[ { "phenotype_id": "PH905", "phenotype_version_id": 1889, "name": "Sore Throat", "definition": "Objectives: \n\nTo examine variations across general practices and factors associated with antibiotic prescribing for common infections in UK primary care to identify potential targets for improvement and optimization of prescribing.\n\n\nMethods: \n\nOral antibiotic prescribing for common infections was analysed using anonymized UK primary care electronic health records between 2000 and 2015 using the Clinical Practice Research Datalink (CPRD). The rate of prescribing for each condition was observed over time and mean change points were compared with national guideline updates. Any correlation between the rate of prescribing for each infectious condition was estimated within a practice. Predictors of prescribing were estimated using logistic regression in a matched patient cohort (1:1 by age, sex and calendar time).\n\n\nResults: \n\nOver 8 million patient records were examined in 587 UK general practices. Practices varied considerably in their propensity to prescribe antibiotics and this variance increased over time. Change points in prescribing did not reflect updates to national guidelines. Prescribing levels within practices were not consistent for different infectious conditions. A history of antibiotic use significantly increased the risk of receiving a subsequent antibiotic (by 22%–48% for patients with three or more antibiotic prescriptions in the past 12months), as did higher BMI, history of smoking and flu vaccinations. Other drivers for receiving an antibiotic varied considerably for each condition.\n\n\nConclusions: \n\nLarge variability in antibiotic prescribing between practices and within practices was observed. Prescribing guidelines alone do not positively influence a change in prescribing, suggesting more targeted interventions are required to optimize antibiotic prescribing in the UK.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Victoria Palin, Anna Molter, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa, Antibiotic prescribing for common infections in UK general practice variability and drivers. Journal of Antimicrobial Chemotherapy, 74:2440-2450, 2019." } ], "validation": "", "citation_requirements": "", "created": "2022-04-04T07:09:23.290406Z", "author": "Victoria Palin, Anna Molter, Miguel Belmonte, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2022-04-04T07:09:23.290431Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Read codes v2", "value": 5 } ], "event_date_range": "01/01/2000 - 30/06/2015", "concept_information": [ { "concept_id": 2677, "concept_version_id": 6767, "concept_name": "Sore Throat - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH905", "phenotype_version_id": 1889, "phenotype_name": "Sore Throat", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "1C9..00", "description": "Sore throat symptom", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1C9..11", "description": "Throat soreness", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1C9Z.00", "description": "Sore throat symptom NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA1..00", "description": "Vincent's angina", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA10.00", "description": "Vincent's stomatitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA11.00", "description": "Vincent's gingivitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA1..11", "description": "Trench mouth", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA12.00", "description": "Vincent's pharyngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA1z.00", "description": "Vincent's angina NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA1z.11", "description": "Vincent's laryngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "AA1z.12", "description": "Vincent's tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H02..00", "description": "Acute pharyngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H021.00", "description": "Acute phlegmonous pharyngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H02..11", "description": "Sore throat NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H02..12", "description": "Viral sore throat NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H02..13", "description": "Throat infection - pharyngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H022.00", "description": "Acute ulcerative pharyngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H023.00", "description": "Acute bacterial pharyngitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H023z00", "description": "Acute bacterial pharyngitis NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H02z.00", "description": "Acute pharyngitis NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H03..00", "description": "Acute tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H030.00", "description": "Acute erythematous tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H031.00", "description": "Acute follicular tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H03..11", "description": "Throat infection - tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H03..12", "description": "Tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H032.00", "description": "Acute ulcerative tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H033.00", "description": "Acute catarrhal tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H035.00", "description": "Acute bacterial tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H035100", "description": "Acute staphylococcal tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H035z00", "description": "Acute bacterial tonsillitis NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H037.00", "description": "Recurrent acute tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H03z.00", "description": "Acute tonsillitis NOS", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H14y500", "description": "Caseous tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H14y600", "description": "Lingular tonsillitis", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R041.00", "description": "[D]Throat pain", "attributes": { "Entity type": "res70: Sore throat", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/wcqk-wz89", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 1889, "version_name": "Sore Throat", "version_date": "2022-04-04T07:09:23.316959Z", "is_published": true, "is_latest": true } ] } ]