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01.02.2013 | original article | Ausgabe 3-4/2013

Wiener klinische Wochenschrift 3-4/2013

The antibiotic prescription and redemption gap and opportunistic CRP point-of-care testing. A cross-sectional study in primary health care from Eastern Austria

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 3-4/2013
Autoren:
MD, MPH Kathryn Hoffmann, Mag. Anna Katharina Leifheit, Berthold Reichardt, Univ.-Prof. Dr. Manfred Maier

Summary

Objective

The aim of this study was to analyse the frequency of C-reactive protein (CRP) rapid test use by general practitioners (GPs), the role of the test in the antibiotic treatment decisions and the efficacy of the test in a primary care setting, with special emphasis on the redemption rate of antibiotic prescriptions.

Design

For this cross-sectional study, GPs documented their CRP test use for 2.5 years. In addition, demographic and the antibiotic prescription and redemption data of the patients were documented. Three groups were clustered according to the three possible CRP test results (1: < 10 mg/l, 2: 10–30 mg/l, 3: > 30 mg/l); analyses were conducted by using descriptive statistical methods and tests.

Results

Thirty GPs documented 692 initial CRP tests. The antibiotic prescription rate was 9.2 % for the first, 71.7 % for the second and 98.7 % for the third group (p < 0.001). A difference between the patients of the three CRP groups according to the redemption rate of antibiotic prescriptions (30.8 vs. 62.7 vs. 64.0 %; p = 0.013) could be found, with the lowest rate in the first group. Overall, 16.3 % of the patients filled an antibiotic at a pharmacy that was not in accordance with the CRP test result documentation form.

Conclusion

The CRP test results show an association with both the antibiotic prescribing and redemption behaviour. Noticeable was the antibiotic redemption behaviour of the patients: 36 % of patients with a CRP test result over 30 did not fill the antibiotic prescribed which is an important finding related to patients adherence and of special interest due to the fact that none of these patients had a hospital admission afterwards. On the contrary, nearly one-fifth of the patients who did not get an antibiotic in connection with the CRP test result finally filled an antibiotic prescription.

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