Abstract
Study design
A retrospective cross-sectional study.
Objective
To identify who prescribes outpatient antibiotics among a primary care spinal cord injury (SCI) cohort.
Setting
ICES databases in Ontario, Canada.
Methods
A cohort of individuals with SCI were retrospectively identified using a tested-algorithm and chart reviews in a primary care electronic medical records database. The cohort was linked to a drug dispensing database to obtain outpatient antibiotic prescribing information, and prescriber details were obtained from a physician database.
Results
Final cohort included three hundred and twenty individuals with SCI. The average annual number of antibiotic courses dispensed for the SCI cohort was 2.0 ± 6.2. For dispensed antibiotics, 58.9% were prescribed by rostered-primary care practice physicians, compared to 17.9% by emergency and non-rostered primary care physicians, 17.4% by specialists and 6.1% by non-physician prescribers. Those who lived in urban areas and rural areas, compared to those who lived in suburban areas, were more likely to receive antibiotics from emergency and non-rostered primary care physicians than from rostered-primary care practice physicians.
Conclusion
Although individuals with SCI received outpatient antibiotic prescriptions from multiple sources, physicians from an individual’s rostered-primary care practice were the main antibiotic prescribers. As such, interventions to optimize antibiotics use in the SCI population should target the primary care practice.
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Discover the latest articles, news and stories from top researchers in related subjects.Data availability
The dataset from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers prohibit ICES from making the dataset publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS (email: das@ices.on.ca). The full dataset creation plan and underlying analytic code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification.
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Acknowledgements
This study was supported by the ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). We thank IQVIA Solutions Canada Inc. for use of their Drug Information File. Parts of this material are based on data and/or information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed in the material are those of the authors, and not necessarily those of CIHI. Thank you to Jun Guan, Zhiyin Li, and staff at ICES for their contributions to this paper.
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All authors contributed to the development of this paper, its study design and interpretation of results. AS conceptualized the study, analyzed the data, interpreted results, and wrote the manuscript. SBJ guided the data analyses and development of manuscript. SBJ, KT, MP, AMM, and BCC helped with the overall interpretation of findings, as well as reviewed and edited the manuscript.
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The use of data in this project was authorized under section 45 of Ontario’s Personal Health Information Protection Act, which does not require further review by a Research Ethics Board.
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Senthinathan, A., Penner, M., Tu, K. et al. Identifying prescribers of antibiotics in a primary care spinal cord injury cohort. Spinal Cord Ser Cases 10, 3 (2024). https://doi.org/10.1038/s41394-024-00615-8
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DOI: https://doi.org/10.1038/s41394-024-00615-8
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