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Background: Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescribing style within and across groups of GPs from six countries. Methods: Cross-sectional study with the inclusion of 457 GPs and 6394 sore throat patients. We describe variation in prescribing antibiotics for sore throat patients across six countries and assess whether variation in “prescribing style” - understood as a subjective tendency to prescribe - has an important effect on variation in prescription of antibiotics by using the concept of prescribing style as a latent variable in a multivariable model. We report variation as a Median Odds Ratio (MOR) which is the transformation of the random effect variance onto an odds ratio; Thus, MOR = 1 means similar odds or strict homogeneity between GPs' prescribing style, while a MOR higher than 1 denotes heterogeneity in prescribing style. Results: In all countries some GPs always prescribed antibiotics to all their patients, while other GPs never did. After adjusting for patient and GP characteristics, prescribing style in the group of GPs from Russia was about three times more heterogeneous than the prescribing style in the group of GPs from Denmark - Median Odds Ratio (6.8, 95% CI 3.1;8.8) and (2.6, 95% CI 2.2;4.4) respectively. Conclusion: Prescribing style is an important source of variation in prescription of antibiotics within and across countries, even after adjusting for patient and GP characteristics. Interventions aimed at influencing the prescribing style of GPs must encompass context-specific actions at the policy-making level alongside GP-targeted interventions to enable GPs to react more objectively to the external demands that are in place when making the decision of prescribing antibiotics or not. [ABSTRACT FROM AUTHOR]

Aim: As reliable instruments are needed for longitudinal research on the development of nicotine addiction, we evaluated the test-retest reliability of eight survey measures (three scales and five individual item measures). Methods: A paper survey was administered to convenience samples of adolescents in two schools and adults in five workplaces in Argentina and re-administered 1-2 weeks later. Test-retest reliability was assessed with Pearson correlations for continuous measures and kappa statistics for dichotomous measures. Results: Both surveys were completed by 95 adolescent and 88 adult smokers. The modified Fagerström Tolerance Questionnaire ( r == 0.88-0.91), the Hooked on Nicotine Checklist ( r == 0.85-0.91), the Autonomy Over Smoking Scale (0.91-0.96) and items assessing latency to needing a cigarette ( r == 0.85-0.94), the pleasure obtained from smoking ( r == 0.84-0.94), and relaxation obtained from the first cigarette (κ == 0.63-0.67), all showed very good to excellent reliability in both populations. Items assessing experiencing the need to smoke more often than previously and the percent of time smoking because of need appear to be more reliable with adolescents (κ == 0.52 and r == 0.76, respectively) than with adults ( κ == 0.32 and r == 0.51, respectively). Conclusions: This is the first study to simultaneously compare the reliability of multiple smoking measures within individual adolescent and adult smokers. All the eight measures showed adequate reliability for use in longitudinal studies with adolescents and all but one were adequate for use with adults. [ABSTRACT FROM AUTHOR]