Higher GP workload linked to increased antibiotic prescribing, research reveals

Analysis of almost 700 GP surgeries finds significant variation between rates of antibiotic prescribing.

Busy GP surgery

Antibiotic prescribing is higher in busier GP surgeries, a research collaboration between the University of Manchester and Public Health England (PHE) has found.

The researchers, who were funded by the Department of Health and Social Care, studied 15 years’ worth of anonymised antibiotic prescribing data from 690 GP practices across the UK. Their statistical analysis classified each practice as either a low, medium or high prescriber.

They found that half of the variation in prescribing rates between GP practices could be explained by differences in the incidence of common infections such as respiratory tract infections and urinary tract infections.

Practice location, duration of GP consultation and number of GPs per thousand consultations accounted for a further 40% of the variation in prescription rates.

Overall, the research found that in busier practices where there was a higher workload (fewer GPs per thousand consultations) or where the length of the consultation was shorter, antibiotic prescribing was higher.

“In order to tackle antibiotic resistance, it’s crucial that we gain a better understanding of the key factors that influence antibiotic prescribing and that can identify patients at higher risk of developing infection-related complications,” said Tjeerd van Staa, lead researcher and professor of health e-research at the University of Manchester.

Van Staa’s team have made all of the anonymised health data available in the form of a new digital dashboard to those working in an approved healthcare, research or government institution.

The dashboard was developed for a range of stakeholders including the Department of Health, clinical commissioning groups, local authorities and NHS England to better understand the existing landscape and help meet the government’s target of halving the number of inappropriate prescriptions by 2020.

“GP surgeries vary greatly and this work highlights that each has its own characteristics that drive antibiotic prescribing,” said William Welfare, a consultant for PHE. “However, we also know that public demand for antibiotics puts pressure on GPs and we launched the Keep Antibiotics Working campaign to raise awareness of appropriate antibiotic use and to encourage behavioural change among the public.”

Welfare also referred to available guidance in the form of the TARGET antibiotic toolkit, developed by PHE and the Royal College of GPs, and the National Institute of Health and Care Excellence guidance on antimicrobial prescribing for common infections.

Last updated
The Pharmaceutical Journal, PJ, December 2018, Vol 301, No 7920;301(7920):DOI:10.1211/PJ.2018.20205776

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