Misuse of Delayed Antibiotic Rx

1
Misuse of Delayed Antibiotic Rx

• Lauren Brown
• Courtney Jones
• Eric Payne
• Fred Wilson

2
Null Hypothesis

• Patients use delayed antibiotic prescriptions as
  directed by physicians for upper respiratory
  infections.

3
Setting and Subjects

• Recruit patients presenting to primary care for
  sx related to
• URI
• Sinusitis
• Bronchitis

4
Setting and Subjects

• Inclusion/Exclusion Criteria
• Inclusion
• An adult gt18
• Patient had obtained Rx for any of the following
  dx URI, bronchitis, sinusitis
• Exclusion
• Those unable to complete the survey due to
  language, educational, or mental deficiency
  barriers

5
Variables and Measures

• To assess whether patients took their Rx as
  directed

6
Variables and Measures

• Survey
• Consisting of three sections
• A Demographic information
• B Prior experience with antibiotic prescriptions
• C Assess use of current prescription
• Survey will take 5-10 minutes to complete

7
Variables and Measures

• Did patient fill prescription?
• Was prescription filled gt3days after visit?
• Was prescription filled with worsening symptoms?
• Was prescription filled due to onset or worsening
  of fever?
• Would patient consider using prescription at a
  later date without consulting a physician?

8
Variables and Measures

• Would patient consider allowing others to use
  prescription without consulting a physician?
• Was prescription taken?
• Was prescription taken gt3days after prescribed?
• Was prescription taken with worsening symptoms?
• Was prescription taken with onset or worsening of
  fever?
• Did you understand physicians instructions for
  filling and taking the prescription?

9
Variables and Measures

• Predictor Variables
• Age
• Gender
• Education Level
• Annual Income
• Type of Insurance
• Previous antibiotic Rx received in the last year

10
Procedures

• A letter will be sent to 500 family practice and
  internal medicine offices inquiring about
  willingness to participate and enroll patients in
  study

11
Procedures

• All patients gt18 years old with diagnoses
  established previously will be asked if they
  would be willing to complete a 5 minute anonymous
  survey

12
Procedures

• Patients that agree will
• Receive a questionnaire 2 wks following their
  appointment, with a pre-addressed stamped
  envelope for returning the completed survey
• Participants who fail to complete the survey will
  be called within four weeks following their
  appointment for completion over the phone

13
Data Analysis

• Descriptive study with dichotomous variables
  requires 384 participants
• Response rate 50-60
• Worst case scenario 50 misuse
• -confidence interval 95, 10 margin of error
• Estimated using Dillman method attempts to gain
  generalizable survey response by reducing
  coverage error, sampling error,measurement error
  and non-response error.

14
Data analysis, cont.

• Descriptive dichotomous variables, identify
  trends, mean, median, standard deviation
• Analytical associations between dichotomous
  outcome variables and predictor variables using
  cross-tabulations and scatterplots

15
Human Subjects Concerns

• Limited concerns due to the anonymous nature of
  our survey
• Only real issue is to maintain that the
  information is kept confidential from patients
  physician, and will therefore increase the chance
  that patients will be forthright with their
  responses