Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis
Objective: This study was aimed at evaluating the appropriateness of use and interpretation of rapid antigen detection testing (RADT) and antibiotic prescribing for acute pharyngitis six years after a multifaceted intervention. Design: Before-and-after audit-based study. Location: Primary care centr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Spanish |
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Elsevier
2020-11-01
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| Series: | Atención Primaria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0212656720301293 |
| _version_ | 1818403489363001344 |
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| author | José M. Molero Gloria Cordoba Beatriz González López-Valcárcel Ana Moragas Juan E. Losa Carles Llor |
| author_facet | José M. Molero Gloria Cordoba Beatriz González López-Valcárcel Ana Moragas Juan E. Losa Carles Llor |
| author_sort | José M. Molero |
| collection | DOAJ |
| description | Objective: This study was aimed at evaluating the appropriateness of use and interpretation of rapid antigen detection testing (RADT) and antibiotic prescribing for acute pharyngitis six years after a multifaceted intervention. Design: Before-and-after audit-based study. Location: Primary care centres in eight autonomous Communities. Participants: General practitioners (GP) who had participated in the HAPPY AUDIT intervention study in 2008 and 2009 were invited to participate in a third audit-based study six years later (2015). Method: RADTs were provided to the participating practices and the GPs were requested to consecutively register all adults with acute pharyngitis. A registration form specifically designed for this study was used. Results: A total of 121 GPs out of the 210 who participated in the first two audits agreed to participate in the third audit (57.6%). They registered 3394 episodes of pharyngitis in the three registrations. RADTs were used in 51.7% of all the cases immediately after the intervention, and in 49.4% six years later. Antibiotics were prescribed in 21.3% and 36.1%, respectively (P < .001), mainly when tonsillar exudates were present, and in 5.3% and 19.2% of those with negative RADT results (P< .001). On adjustment for covariables, compared to the antibiotic prescription observed just after the intervention, significantly more antibiotics were prescribed six years later (odds ratio: 2.24, 95% confidence interval: 1.73–2.89). Conclusions: This study shows that that the long-term impact of a multifaceted intervention, focusing on the use and interpretation of RADT in patients with acute pharyngitis, is reducing. Resumen: Objetivo: Evaluar la adecuación del uso e interpretación de las técnicas antigénicas rápidas (TAR) y la prescripción antibiótica en la faringitis aguda 6 años después de haber realizado una intervención multifacética. Diseño: Estudio antes-después basado en una auditoria. Emplazamiento: Centros de salud en 8 comunidades autónomas. Participantes: Se invitaron a médicos de familia (MF) que ya habían participado en el estudio de intervención HAPPY AUDIT en 2008 y 2009 a un nuevo AUDIT 6 años después (2015). Método: Se proporcionaron TAR a los centros participantes, y se pidió a los MF que registraran consecutivamente a todos los adultos con faringitis aguda. Usamos un registro diseñado específicamente para este estudio. Resultados: Ciento veintiuno MF de los 210 que participaron en los primeros registros (57,6%) aceptaron a participar en el tercer registro. Se registraron 3.394 episodios de faringitis agudas en las 3 auditorías. Se usaron TAR en el 51,7% de los casos inmediatamente después de la intervención y en el 49,4%, 6 años después. Se prescribieron antibióticos en el 21,3%y 36,1%, respectivamente (p < 0,001), principalmente cuando había exudado amigdalar y en el 5,3 y 19,2% de los resultados de TAR negativos (p < 0,001). Después de ajustar por las distintas covariables, comparado con la prescripción antibiótica observada justo después de la intervención, prescribieron significativamente más antibióticos 6 años más tarde (odds ratio: 2,24 [IC 95%: 1,73-2,89]). Conclusiones: Este estudio muestra que se reduce el impacto de una intervención multifacética a largo plazo enfocada al uso e interpretación de TAR en pacientes con faringitis aguda. |
| first_indexed | 2024-12-14T08:25:04Z |
| format | Article |
| id | doaj.art-ab09f71d2e374b6298bb7f6017b77fad |
| institution | Directory Open Access Journal |
| issn | 0212-6567 |
| language | Spanish |
| last_indexed | 2024-12-14T08:25:04Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Atención Primaria |
| spelling | doaj.art-ab09f71d2e374b6298bb7f6017b77fad2022-12-21T23:09:41ZspaElsevierAtención Primaria0212-65672020-11-01529637644Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitisJosé M. Molero0Gloria Cordoba1Beatriz González López-Valcárcel2Ana Moragas3Juan E. Losa4Carles Llor5San Andrés Health Centre, Department Preventive Medical Specialties and Public Health, University Rey Juan Carlos, Madrid, SpainSection of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, DenmarkDepartment of Quantitative Methods for Economics and Management, University of Las Palmas, Las Palmas de Gran Canaria, Canary Islands, SpainUniversity Rovira i Virgili, Jaume I Health Centre, Tarragona, Catalonia, SpainDepartment of Health Sciences II-Facultad de Ciencias de la Salud, University Juan Carlos, Hospital Universitario Fundación Alarcón, Madrid, SpainSection of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain; Corresponding author.Objective: This study was aimed at evaluating the appropriateness of use and interpretation of rapid antigen detection testing (RADT) and antibiotic prescribing for acute pharyngitis six years after a multifaceted intervention. Design: Before-and-after audit-based study. Location: Primary care centres in eight autonomous Communities. Participants: General practitioners (GP) who had participated in the HAPPY AUDIT intervention study in 2008 and 2009 were invited to participate in a third audit-based study six years later (2015). Method: RADTs were provided to the participating practices and the GPs were requested to consecutively register all adults with acute pharyngitis. A registration form specifically designed for this study was used. Results: A total of 121 GPs out of the 210 who participated in the first two audits agreed to participate in the third audit (57.6%). They registered 3394 episodes of pharyngitis in the three registrations. RADTs were used in 51.7% of all the cases immediately after the intervention, and in 49.4% six years later. Antibiotics were prescribed in 21.3% and 36.1%, respectively (P < .001), mainly when tonsillar exudates were present, and in 5.3% and 19.2% of those with negative RADT results (P< .001). On adjustment for covariables, compared to the antibiotic prescription observed just after the intervention, significantly more antibiotics were prescribed six years later (odds ratio: 2.24, 95% confidence interval: 1.73–2.89). Conclusions: This study shows that that the long-term impact of a multifaceted intervention, focusing on the use and interpretation of RADT in patients with acute pharyngitis, is reducing. Resumen: Objetivo: Evaluar la adecuación del uso e interpretación de las técnicas antigénicas rápidas (TAR) y la prescripción antibiótica en la faringitis aguda 6 años después de haber realizado una intervención multifacética. Diseño: Estudio antes-después basado en una auditoria. Emplazamiento: Centros de salud en 8 comunidades autónomas. Participantes: Se invitaron a médicos de familia (MF) que ya habían participado en el estudio de intervención HAPPY AUDIT en 2008 y 2009 a un nuevo AUDIT 6 años después (2015). Método: Se proporcionaron TAR a los centros participantes, y se pidió a los MF que registraran consecutivamente a todos los adultos con faringitis aguda. Usamos un registro diseñado específicamente para este estudio. Resultados: Ciento veintiuno MF de los 210 que participaron en los primeros registros (57,6%) aceptaron a participar en el tercer registro. Se registraron 3.394 episodios de faringitis agudas en las 3 auditorías. Se usaron TAR en el 51,7% de los casos inmediatamente después de la intervención y en el 49,4%, 6 años después. Se prescribieron antibióticos en el 21,3%y 36,1%, respectivamente (p < 0,001), principalmente cuando había exudado amigdalar y en el 5,3 y 19,2% de los resultados de TAR negativos (p < 0,001). Después de ajustar por las distintas covariables, comparado con la prescripción antibiótica observada justo después de la intervención, prescribieron significativamente más antibióticos 6 años más tarde (odds ratio: 2,24 [IC 95%: 1,73-2,89]). Conclusiones: Este estudio muestra que se reduce el impacto de una intervención multifacética a largo plazo enfocada al uso e interpretación de TAR en pacientes con faringitis aguda.http://www.sciencedirect.com/science/article/pii/S0212656720301293FaringitisIntervenciónPrueba antigénica rápidaAgentes antibacterianos |
| spellingShingle | José M. Molero Gloria Cordoba Beatriz González López-Valcárcel Ana Moragas Juan E. Losa Carles Llor Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis Atención Primaria Faringitis Intervención Prueba antigénica rápida Agentes antibacterianos |
| title | Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis |
| title_full | Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis |
| title_fullStr | Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis |
| title_full_unstemmed | Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis |
| title_short | Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis |
| title_sort | long term impact of an intervention on rapid antigen detection tests in acute pharyngitis |
| topic | Faringitis Intervención Prueba antigénica rápida Agentes antibacterianos |
| url | http://www.sciencedirect.com/science/article/pii/S0212656720301293 |
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