Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints
Abstract Background No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods This was a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08400-y |
| _version_ | 1797795882302701568 |
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| author | Swetha Ramanathan Charlesnika T. Evans Ronald C. Hershow Gregory S. Calip Susan Rowan Colin Hubbard Katie J. Suda |
| author_facet | Swetha Ramanathan Charlesnika T. Evans Ronald C. Hershow Gregory S. Calip Susan Rowan Colin Hubbard Katie J. Suda |
| author_sort | Swetha Ramanathan |
| collection | DOAJ |
| description | Abstract Background No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015–2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed). Results A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90–0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59–1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96–1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07–1.15). Conclusions VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting. |
| first_indexed | 2024-03-13T03:24:44Z |
| format | Article |
| id | doaj.art-e4947ecdb33a4e87847fcac9456c5824 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-13T03:24:44Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e4947ecdb33a4e87847fcac9456c58242023-06-25T11:10:10ZengBMCBMC Infectious Diseases1471-23342023-06-0123111210.1186/s12879-023-08400-yComparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic jointsSwetha Ramanathan0Charlesnika T. Evans1Ronald C. Hershow2Gregory S. Calip3Susan Rowan4Colin Hubbard5Katie J. Suda6School of Public Heath, University of Illinois at ChicagoCenter of Innovation for Complex Chronic Healthcare, Hines VA HospitalSchool of Public Heath, University of Illinois at ChicagoCollege of Pharmacy, University of Illinois at ChicagoCollege of Dentistry, University of Illinois at ChicagoDivision of Hospital Medicine, Department of Medicine, University of California San FranciscoCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare SystemAbstract Background No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015–2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed). Results A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90–0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59–1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96–1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07–1.15). Conclusions VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting.https://doi.org/10.1186/s12879-023-08400-yDentistsAntibioticsProphylaxisVA DentistryPrivate PracticeGuideline Concordant Prescribing |
| spellingShingle | Swetha Ramanathan Charlesnika T. Evans Ronald C. Hershow Gregory S. Calip Susan Rowan Colin Hubbard Katie J. Suda Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints BMC Infectious Diseases Dentists Antibiotics Prophylaxis VA Dentistry Private Practice Guideline Concordant Prescribing |
| title | Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints |
| title_full | Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints |
| title_fullStr | Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints |
| title_full_unstemmed | Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints |
| title_short | Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints |
| title_sort | comparison of guideline concordant antibiotic prophylaxis in veterans affairs and non veterans affairs dental settings among those with cardiac conditions or prosthetic joints |
| topic | Dentists Antibiotics Prophylaxis VA Dentistry Private Practice Guideline Concordant Prescribing |
| url | https://doi.org/10.1186/s12879-023-08400-y |
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