[ { "phenotype_id": "PH906", "phenotype_version_id": 1891, "name": "Upper Respiratory Tract Infection (URTI)", "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": "2022-04-04T07:09:24.992466Z", "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": "2022-04-04T07:09:24.992492Z", "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": 2678, "concept_version_id": 6769, "concept_name": "Upper Respiratory Tract Infection (URTI) - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH906", "phenotype_version_id": 1891, "phenotype_name": "Upper Respiratory Tract Infection (URTI)", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "H0...00", "description": "Acute respiratory infections", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H04..00", "description": "Acute laryngitis and tracheitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040.00", "description": "Acute laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040000", "description": "Acute oedematous laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040100", "description": "Acute ulcerative laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040200", "description": "Acute catarrhal laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040300", "description": "Acute phlegmonous laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040600", "description": "Acute suppurative laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040x00", "description": "Acute bacterial laryngitis unspecified", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H040z00", "description": "Acute laryngitis NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H041.00", "description": "Acute tracheitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H041000", "description": "Acute tracheitis without obstruction", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H041100", "description": "Acute tracheitis with obstruction", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H041z00", "description": "Acute tracheitis NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H042.00", "description": "Acute laryngotracheitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H042000", "description": "Acute laryngotracheitis without obstruction", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H042100", "description": "Acute laryngotracheitis with obstruction", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H042.11", "description": "Laryngotracheitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H042z00", "description": "Acute laryngotracheitis NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H043.00", "description": "Acute epiglottitis (non strep)", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H043000", "description": "Acute epiglottitis without obstruction", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H043200", "description": "Acute obstructive laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H043z00", "description": "Acute epiglottitis NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H04z.00", "description": "Acute laryngitis and tracheitis NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H05..00", "description": "Other acute upper respiratory infections", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H050.00", "description": "Acute laryngopharyngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H051.00", "description": "Acute upper respiratory tract infection", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H052.00", "description": "Pharyngotracheitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H053.00", "description": "Tracheopharyngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H054.00", "description": "Recurrent upper respiratory tract infection", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H055.00", "description": "Pharyngolaryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H05y.00", "description": "Other upper respiratory infections of multiple sites", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H05z.00", "description": "Upper respiratory infection NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H05z.11", "description": "Upper respiratory tract infection NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H0y..00", "description": "Other specified acute respiratory infections", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H0z..00", "description": "Acute respiratory infection NOS", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "H160100", "description": "Chronic catarrhal laryngitis", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Hyu0.00", "description": "[X]Acute upper respiratory infections", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Hyu0100", "description": "[X]Acute pharyngitis due to other specified organisms", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Hyu0200", "description": "[X]Acute tonsillitis due to other specified organisms", "attributes": { "Entity type": "res70: URTI", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/fnxk-3a17", "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": 1891, "version_name": "Upper Respiratory Tract Infection (URTI)", "version_date": "2022-04-04T07:09:25.017464Z", "is_published": true, "is_latest": true } ] } ]