Reducing variation in antibacterial prescribing rates for ‘cough/cold’ and sore throat between 1993 and 2001: Regional analyses using the general practice research database

Smith, S.; Smith, G.E.; Heatlie, H.; Bashford, J.N.R.; Ashcroft, D.M.; Verlander, N.Q.; Duckworth, G.J.; Mason, B.; Smyth, B.; Maxwell, S.

doi:10.1016/j.puhe.2006.02.007

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Volume 120, Issue 8 , Pages 752-759, August 2006

Reducing variation in antibacterial prescribing rates for ‘cough/cold’ and sore throat between 1993 and 2001: Regional analyses using the general practice research database

S. Smith
- Regional Surveillance Unit, Health Protection Agency West Midlands, Birmingham, UK
- Corresponding author. Regional Surveillance Unit, Health Protection Agency West Midlands, 9th Floor, Ladywood House, 45 Stephenson Street, Birmingham, B2 404, UK. Tel.: +4401216348757; fax: +4401216348776.
G.E. Smith
- Regional Surveillance Unit, Health Protection Agency West Midlands, Birmingham, UK
H. Heatlie
- Department of Medicines Management, Keele University, Keele, Staffordshire, UK
J.N.R. Bashford
- Department of Medicines Management, Keele University, Keele, Staffordshire, UK
D.M. Ashcroft
- School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK
N.Q. Verlander
- Health Protection Agency Centre for Infections, London, UK
G.J. Duckworth
- Health Protection Agency Centre for Infections, London, UK
B. Mason
- CDSC Wales, Roath, Cardiff, UK
B. Smyth
- Communicable Disease Surveillance Centre (NI), Belfast City Hospital, Belfast, UK
S. Maxwell
- Clinical Pharmacology Unit, University of Edinburgh, Queen's Medical Research Institute, Royal Infirmary of Edinburgh, Edinburgh, UK

Received 9 March 2005; received in revised form 13 January 2006; accepted 15 February 2006.

Summary

Objective

To use the General Practice Research Database (GPRD) to explore the regional variation in prescribing for single diagnostic episodes of ‘cough/cold’ and sore throat and how this changed between 1993 and 2001.

Methods

Data from the GPRD was used to conduct a longitudinal survey of morbidity and antibiotic prescribing data.

Results

Nationally there has been a substantial reduction in diagnosed episodes per 1000 patient years at risk for both diagnoses: from 104.6 (104.0–105.2) to 86.5 (86.0–86.9) for cough/cold (−17.3%) and from 102.8 (102.2–103.4) to 69.2 (68.8–69.6) for sore throat (−32.6%). In addition to the changes in diagnostic rate there have been reductions in diagnosis-related prescribing: from 41.8% to 34.8% of cough/cold episodes (−7.0%) and from 77.3% to 60.8% of sore throat episodes (−16.4%). These aggregated data conceal wide regional variations. For cough/cold the change in prescribing rate during the study varied from −16.0% to +5.3% and for sore throat from −28.3% to −7.3%.

Conclusions

In addition to a substantial reduction in diagnosis of cough/cold and sore throat, there has been a reduction in diagnosis-related prescribing episodes in almost all regions. Although there continues to be regional variation in diagnosis-related prescribing this has reduced substantially over the 9-year study period.

Keywords: Antimicrobial prescribing, Cough/cold, Sore throat, General Practice Research Database