RT Journal Article
SR Electronic
T1 Antibiotics for acute cough: an international observational study of patient adherence in primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e429
OP e437
DO 10.3399/bjgp12X649124
VO 62
IS 599
A1 Nick A Francis
A1 David Gillespie
A1 Jacqueline Nuttall
A1 Kerenza Hood
A1 Paul Little
A1 Theo Verheij
A1 Samuel Coenen
A1 Jochen W Cals
A1 Herman Goossens
A1 Christopher C Butler
YR 2012
UL http://bjgp.org/content/62/599/e429.abstract
AB Background Non-adherence to acute antibiotic prescriptions is poorly described and may impact on clinical outcomes, healthcare costs, and interpretation of research. It also results in leftover antibiotics that could be used inappropriately.Aim To describe adherence to antibiotics prescribed for adults presenting with acute cough in primary care, factors associated with non-adherence, and associated recovery.Design and setting Prospective observational cohort study in general practices in 14 European primary care networks.Method GPs recorded patient characteristics and prescribing decisions for adults with acute cough or clinical presentation suggestive of lower respiratory tract infection. Patients recorded antibiotic consumption and daily symptoms over 28 days. Rates of adherence to prescribed antibiotics were assessed, and factors associated with non-adherence were identified using logistic regression. Recovery was compared using a Cox proportional hazards model.Results Of 2520 patients prescribed immediate or no antibiotics at the index consultation, 282 (11.2%) took an antibiotic during the follow-up period that was not prescribed for them at the index consultation. Of these, 38.1% had no reconsultations during this period. Prior duration of symptoms, antibiotic treatment duration, antibiotic choice, and primary care network were all associated with adherence. There was no difference in time to recovery between those who were prescribed antibiotics at the index consultation and were fully adherent, partially adherent, and non-adherent.Conclusion Non-adherence to antibiotics for acute cough or lower respiratory tract infection is common. Duration of treatment, choice of antibiotic, and setting were associated with adherence but adherence to treatment was not associated with differences in recovery.