Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study
Objective To examine the association between area-level education and the local growth trajectories in antibacterial dispensing rates in Norwegian municipalities among children under 3 years old.Design Retrospective, longitudinal study using individual primary care prescription data from the Norwegi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/9/e058491.full |
| _version_ | 1811210413415596032 |
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| author | Anne Elise Eggen Kristian Svendsen Sigbjørn Svalestuen Lars Småbrekke |
| author_facet | Anne Elise Eggen Kristian Svendsen Sigbjørn Svalestuen Lars Småbrekke |
| author_sort | Anne Elise Eggen |
| collection | DOAJ |
| description | Objective To examine the association between area-level education and the local growth trajectories in antibacterial dispensing rates in Norwegian municipalities among children under 3 years old.Design Retrospective, longitudinal study using individual primary care prescription data from the Norwegian Prescription Database for the period 2006–2016. Data were collected on the date of dispensing, the type and amount of antibiotic, the patient’s age, sex and municipality of residence and linked to municipality-level statistics on education available from Statistics Norway. We used multilevel growth curve modelling, with a linear trend variable modelled as a random effect and a cross-level interaction between linear trends and the proportion of the population in the municipality having received a university or college education.Setting The local government level in Norway. The sample includes all municipalities over the study period.Outcome measure Number of dispensed antibacterial prescriptions per 100 children in individual primary care by municipality and year.Results We identified a significant negative linear trend in the square root of the dispensing rate for children under 3 years old during the period. This trend varied between municipalities. A negative cross-level interaction term between population education levels and random trends showed that municipalities with an average level of population education saw a reduction in their square root dispensing rates of −0.053 (95% CI −0.066 to −0.039) prescriptions per 100 children. Each additional percentage point in population education contributed a further −0.0034 (95% CI −0.006 to –0.001) reduction to the square root dispensing rate.Conclusions Municipalities in which a larger proportion of the local population have high educational achievements have been more successful in reducing antibacterial dispensing rates in children under 3 years old. Adopting area-level strategies and addressing local community disadvantages may help to optimise practices and prescribing patterns across local communities. |
| first_indexed | 2024-04-12T04:54:04Z |
| format | Article |
| id | doaj.art-db98a98d16c04c83baf46480b2f61470 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T04:54:04Z |
| publishDate | 2022-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-db98a98d16c04c83baf46480b2f614702022-12-22T03:47:11ZengBMJ Publishing GroupBMJ Open2044-60552022-09-0112910.1136/bmjopen-2021-058491Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective studyAnne Elise Eggen0Kristian Svendsen1Sigbjørn Svalestuen2Lars Småbrekke3Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, NorwayDepartment of Pharmacy, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, NorwayDepartment of Social Science, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, NorwayDepartment of Pharmacy, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, NorwayObjective To examine the association between area-level education and the local growth trajectories in antibacterial dispensing rates in Norwegian municipalities among children under 3 years old.Design Retrospective, longitudinal study using individual primary care prescription data from the Norwegian Prescription Database for the period 2006–2016. Data were collected on the date of dispensing, the type and amount of antibiotic, the patient’s age, sex and municipality of residence and linked to municipality-level statistics on education available from Statistics Norway. We used multilevel growth curve modelling, with a linear trend variable modelled as a random effect and a cross-level interaction between linear trends and the proportion of the population in the municipality having received a university or college education.Setting The local government level in Norway. The sample includes all municipalities over the study period.Outcome measure Number of dispensed antibacterial prescriptions per 100 children in individual primary care by municipality and year.Results We identified a significant negative linear trend in the square root of the dispensing rate for children under 3 years old during the period. This trend varied between municipalities. A negative cross-level interaction term between population education levels and random trends showed that municipalities with an average level of population education saw a reduction in their square root dispensing rates of −0.053 (95% CI −0.066 to −0.039) prescriptions per 100 children. Each additional percentage point in population education contributed a further −0.0034 (95% CI −0.006 to –0.001) reduction to the square root dispensing rate.Conclusions Municipalities in which a larger proportion of the local population have high educational achievements have been more successful in reducing antibacterial dispensing rates in children under 3 years old. Adopting area-level strategies and addressing local community disadvantages may help to optimise practices and prescribing patterns across local communities.https://bmjopen.bmj.com/content/12/9/e058491.full |
| spellingShingle | Anne Elise Eggen Kristian Svendsen Sigbjørn Svalestuen Lars Småbrekke Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study BMJ Open |
| title | Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study |
| title_full | Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study |
| title_fullStr | Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study |
| title_full_unstemmed | Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study |
| title_short | Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study |
| title_sort | association of area level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in norway a longitudinal retrospective study |
| url | https://bmjopen.bmj.com/content/12/9/e058491.full |
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