Delayed antibiotic prescribing for respiratory tract infections: protocol of an individual patient data meta-analysis
Por:
Stuart, B, Hounkpatin, H, Becque, T, Yao, GQ, Zhu, SH, Alonso-Coello, P, Altiner, A, Arroll, B, Bohning, D, Bostock, J, Bucher, HCC, de la Poza, M, Francis, NA, Gillespie, D, Hay, AD, Kenealy, T, Loffler, C, Mas-Dalmau, G, Munoz, L, Samuel, K, Moore, M, Little, P
Publicada:
1 jun 2019
Resumen:
Introduction Delayed prescribing can be a useful strategy to reduce antibiotic prescribing, but it is not clear for whom delayed prescribing might be effective. This protocol outlines an individual patient data (IPD) meta-analysis of randomised controlled trials (RCTs) and observational cohort studies to explore the overall effect of delayed prescribing and identify key patient characteristics that are associated with efficacy of delayed prescribing.
Methods and analysis A systematic search of the databases Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL Plus and Web of Science was conducted to identify relevant studies from inception to October 2017. Outcomes of interest include duration of illness, severity of illness, complication, reconsultation and patient satisfaction. Study authors of eligible papers will be contacted and invited to contribute raw IPD data. IPD data will be checked against published data, harmonised and aggregated to create one large IPD database. Multilevel regression will be performed to explore interaction effects between treatment allocation and patient characteristics. The economic evaluation will be conducted based on IPD from the combined trial and observational studies to estimate the differences in costs and effectiveness for delayed prescribing compared with normal practice. A decision model will be developed to assess potential savings and cost-effectiveness in terms of reduced antibiotic usage of delayed prescribing and quality-adjusted life years.
Ethics and dissemination Ethical approval was obtained from the University of Southampton Faculty of Medicine Research Ethics Committee (Reference number: 30068). Findings of this study will be published in peer-reviewed academic journals as well as General Practice trade journals and will be presented at national and international conferences. The results will have important public health implications, shaping the way in which antibiotics are prescribed in the future and to whom delayed prescriptions are issued.
PROSPERO registration number CRD42018079400.
Filiaciones:
Stuart, B:
Univ Southampton, Acad Unit Primary Care & Populat Sci, Fac Med, Southampton, Hants, England
Hounkpatin, H:
Univ Southampton, Acad Unit Primary Care & Populat Sci, Fac Med, Southampton, Hants, England
Becque, T:
Univ Southampton, Acad Unit Primary Care & Populat Sci, Fac Med, Southampton, Hants, England
Yao, GQ:
Univ Leicester, Biostat Res Grp, Dept Hlth Sci, Coll Life Sci, Leiceister, England
Zhu, SH:
Univ Southampton, Acad Unit Primary Care & Populat Sci, Fac Med, Southampton, Hants, England
Alonso-Coello, P:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Dept Clin Epidemiol & Publ Hlth, Barcelona, Spain
Altiner, A:
Univ Rostock, Dept Gen Med, Off Educ Affairs, Rostock, Germany
Arroll, B:
Univ Auckland, Dept Gen Practice & Primary Hlth Care, Auckland, New Zealand
Bohning, D:
Univ Southampton, Southampton Stat Sci Res Inst, Southampton, Hants, England
Bostock, J:
Kings Coll London, Div Hlth & Social Care Res, London, England
Bucher, HCC:
Univ Hosp Basel, Basel Inst Clin Epidemiol & Biostat CEB, Basel, Switzerland
Univ Basel, Basel, Switzerland
de la Poza, M:
CAP Doctor Carles Ribas, Inst Catala Salut, Barcelona, Spain
Francis, NA:
Cardiff Univ, Div Populat Med, Sch Med, Cardiff, S Glam, Wales
Gillespie, D:
Cardiff Univ, Ctr Trials Res, Coll Biomed & Life Sci, Cardiff, S Glam, Wales
Hay, AD:
Univ Bristol, Ctr Acad Primary Care, Populat Hlth Sci, Bristol Med Sch, Bristol, Avon, England
Kenealy, T:
Univ Auckland, Dept Gen Practice & Primary Hlth Care, Auckland, New Zealand
Loffler, C:
Rostock Univ, Med Ctr, Inst Gen Practice, Rostock, Germany
Mas-Dalmau, G:
Hosp Santa Creu & Sant Pau, Knowledge & Res Management Unit, Barcelona, Spain
Munoz, L:
Agencia Qualitat & Avaluacio Sanitaries Catalunya, Barcelona, Spain
Samuel, K:
Univ Leeds, ASPIRE PPI Panel, Inst Hlth Sci, Leeds, W Yorkshire, England
Moore, M:
Univ Southampton, Acad Unit Primary Care & Populat Sci, Fac Med, Southampton, Hants, England
Little, P:
Univ Southampton, Acad Unit Primary Care & Populat Sci, Fac Med, Southampton, Hants, England
Gold, Green Published, Green Accepted
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