12 results on '"Hicks LA"'
Search Results
2. Variation in Outpatient Antibiotic Dispensing for Respiratory Infections in Children by Clinician Specialty and Treatment Setting.
- Author
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Agiro A, Gautam S, Wall E, Hackell J, Helm M, Barron J, Zaoutis T, Fleming-Dutra KE, Hicks LA, and Rosenberg A
- Subjects
- Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Outpatients statistics & numerical data, Retrospective Studies, Anti-Bacterial Agents administration & dosage, Drug Utilization statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Respiratory Tract Infections drug therapy
- Abstract
Background: Antibiotics are commonly prescribed for children with acute respiratory infections (ARIs). This study describes the distribution of ARI diagnoses and specifically quantifies antibiotic dispensing for bronchitis and upper respiratory infection (URI) by treatment setting and specialty., Methods: This retrospective, observational cross-sectional study used data from the HealthCore Integrated Research Environment containing claims from 14 commercial health plans for 2012 to 2014. Children (2-17 years) with first-episode ARI were identified by diagnosis of acute otitis media (AOM), sinusitis, pharyngitis, bronchitis or URI with no competing infections or chronic illnesses. Treatment setting was where diagnoses were made: primary care offices, urgent care centers (UCC), retail health clinics (RHCs) or emergency departments. Primary outcome measure was antibiotic prescription fills from pharmacies within 2 days of start of ARI episode., Results: For URI, the highest proportions in antibiotic dispensing were ordered by office-based or UCC family physicians (28% and 30%, respectively) and office-based or UCC nurse practitioners/physician assistants (30% and 29%, respectively). Across all settings and specialties, there was high proportion of antibiotic dispensing for bronchitis (75%). Overall, 48% of 544,531 children diagnosed with ARI filled antibiotics. Nurse practitioners/physician assistants in RHC made the most diagnoses of AOM (24%) and streptococcal pharyngitis (22%)., Conclusions: Outreach efforts to decrease antibiotic dispensing for URI can be focused on office-based and UCC family physicians and nurse practitioners/physician assistants. All specialties need widespread interventions to reduce antibiotic dispensing for bronchitis. RHC nurse practitioners/physician assistants can be targeted to reduce high proportion of AOM and streptococcal pharyngitis diagnoses.
- Published
- 2018
- Full Text
- View/download PDF
3. Comparison of Antibiotic Prescribing in Retail Clinics, Urgent Care Centers, Emergency Departments, and Traditional Ambulatory Care Settings in the United States.
- Author
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Palms DL, Hicks LA, Bartoces M, Hersh AL, Zetts R, Hyun DY, and Fleming-Dutra KE
- Subjects
- Aged, Follow-Up Studies, Humans, Practice Patterns, Physicians', Retrospective Studies, United States, Ambulatory Care Facilities statistics & numerical data, Anti-Bacterial Agents therapeutic use, Drug Prescriptions statistics & numerical data, Drug Utilization statistics & numerical data, Emergency Service, Hospital statistics & numerical data, Respiratory Tract Infections drug therapy
- Published
- 2018
- Full Text
- View/download PDF
4. Antibiotic Expenditures by Medication, Class, and Healthcare Setting in the United States, 2010-2015.
- Author
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Suda KJ, Hicks LA, Roberts RM, Hunkler RJ, Matusiak LM, and Schumock GT
- Subjects
- Humans, United States, Anti-Bacterial Agents economics, Anti-Bacterial Agents therapeutic use, Antimicrobial Stewardship methods, Drug Utilization standards, Health Expenditures statistics & numerical data, Health Expenditures trends
- Abstract
Background: Improving antibiotic use has the potential to decrease healthcare costs by reducing the incidence of antibiotic-resistant infections, antibiotic-associated adverse events, and expenditures due to unnecessary prescriptions. Antibiotic expenditures in 2009 totaled $10.7 billion in the United States. Since then, national and local antibiotic stewardship initiatives have grown. The purpose of this study was to assess trends in antibiotic expenditures by healthcare setting in the United States between 2010 and 2015., Methods: Systemic (nontopical) antibiotic expenditures from January 2010 to December 2015 were extracted from the QuintilesIMS National Sales Perspectives database. These data represent a statistically valid projection of US medication purchases. Regression analyses evaluated trends in expenditures over the study period., Results: Antibiotic expenditures totaled $56.0 billion over the 6-year period; the majority (59.1%) of expenditures were associated with the outpatient setting. Overall antibiotic expenditures in 2015 ($8.8 billion) were 16.6% lower than in 2010 ($10.6 billion). Antibiotic expenditures similarly decreased in the community by 25.5% (P = .05), but outpatient clinics and mail service pharmacy expenditures experienced significant growth (148% and 67% increase, respectively; P < .01 for both). In 2015, 16.5% of antibiotic expenditures in the community were for parenteral formulations, an increase of 25%., Conclusions: From 2010 to 2015, antibiotic expenditures decreased. The majority of antibiotic expenditures were in the outpatient setting, specifically community pharmacies. Expenditures for intravenous agents in the community are increasing and may represent increased use. These results reinforce the importance of antibiotic stewardship efforts across the spectrum of healthcare., (Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.)
- Published
- 2018
- Full Text
- View/download PDF
5. Variation in US outpatient antibiotic prescribing quality measures according to health plan and geography.
- Author
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Roberts RM, Hicks LA, and Bartoces M
- Subjects
- Adolescent, Adult, Ambulatory Care statistics & numerical data, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Databases, Factual, Drug Prescriptions standards, Drug Prescriptions statistics & numerical data, Drug Resistance, Microbial drug effects, Drug Utilization trends, Geography, Guideline Adherence statistics & numerical data, Humans, Infant, Insurance Claim Review statistics & numerical data, Insurance, Health statistics & numerical data, Pharyngitis diagnosis, Pharyngitis microbiology, Practice Guidelines as Topic, Respiratory Tract Infections diagnosis, Respiratory Tract Infections drug therapy, Respiratory Tract Infections microbiology, Streptococcal Infections diagnosis, Streptococcal Infections drug therapy, United States, Ambulatory Care standards, Anti-Bacterial Agents standards, Drug Utilization standards, Insurance, Health standards, Pharyngitis drug therapy, Quality Indicators, Health Care
- Abstract
Objectives: Antibiotic prescribing has become increasingly viewed as an issue related to patient safety and quality of care. The objective of this study was to better understand the differences between health plan reporting and the geographic variation seen in quality measures related to antibiotic use., Study Design: We focused on 3 measures from the Healthcare Effectiveness Data and Information Set (HEDIS) related to antibiotic prescribing and testing to guide antibiotic prescribing., Methods: We analyzed data for 3 relevant measures for the years 2008 to 2012, including only commercial health plans. We analyzed the following 3 HEDIS measures: 1) "Appropriate Testing for Children With Pharyngitis," 2) "Appropriate Treatment for Children With Upper Respiratory Infections," and 3) "Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis.", Results: Out of these 3 measures, health plans consistently performed poorly on the adult bronchitis measure. Performance was better on the 2 measures focused on the pediatric population. We also saw geographic variation between measures when looking at Census divisions across all years., Conclusions: There is wide variation between individual health plan performance on the measures related to antibiotic use. Geographic differences were also observed on these measures, with health plans in the South Central Census division performing worse than other parts of the country. Stakeholders, such as public health, advocacy groups, foundations, and professional societies, interested in improving the quality of care that patients receive related to antibiotic use in the outpatient setting should consider how existing measures and working with health plans could be used to improve prescribing.
- Published
- 2016
6. Trends in the use of prescription antibiotics: NHANES 1999-2012.
- Author
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Frenk SM, Kit BK, Lukacs SL, Hicks LA, and Gu Q
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Cross-Sectional Studies, Drug Prescriptions standards, Drug Utilization standards, Female, Health Policy, Humans, Infant, Infant, Newborn, Male, Middle Aged, Nutrition Surveys, United States, Young Adult, Anti-Bacterial Agents therapeutic use, Drug Utilization trends
- Abstract
Objectives: The objectives of this study were: to examine trends in the use of prescription antibiotics overall and by population subgroups between 1999 and 2012; and to examine trends in the use of categories of antibiotics and individual antibiotics., Methods: Use of antibiotics was examined among 71 444 participants in the nationally representative National Health and Nutrition Examination Survey (NHANES; 1999-2012). Use of an antibiotic in the past 30 days was the main outcome variable. Analyses of trends were conducted overall and separately by population subgroups (i.e. age, sex, race/Hispanic origin, health insurance status and respiratory conditions) across four time periods (1999-2002, 2003-06, 2007-10 and 2011-12)., Results: The percentage of the US population that used a prescription antibiotic in the past 30 days significantly declined from 6.1% in 1999-2002 to 4.1% in 2011-12 (P < 0.001). Declines were also identified for five age groups (0-1 year, 6-11 years, 12-17 years, 18-39 years and 40-59 years), both sexes, non-Hispanic white and non-Hispanic black persons, persons with and without insurance and among those who currently had asthma. Significant declines were also observed for three categories of antibiotics (penicillins, cephalosporins and macrolide derivatives). Of the most common antibiotics prescribed, only amoxicillin use decreased significantly., Conclusions: Overall, there was a significant decline in the use of antibiotics between 1999-2002 and 2011-12. Due to concerns about antimicrobial resistance, it is important to continue monitoring the use of antibiotics., (Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.)
- Published
- 2016
- Full Text
- View/download PDF
7. Variability in Antibiotic Prescribing: An Inconvenient Truth.
- Author
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Hicks LA and Blaser MJ
- Subjects
- Humans, Anti-Bacterial Agents therapeutic use, Drug Utilization
- Published
- 2015
- Full Text
- View/download PDF
8. Minimizing Antibiotic Misuse through Evidence-Based Management of Outpatient Acute Respiratory Infections.
- Author
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Sanchez GV, Fleming-Dutra KE, and Hicks LA
- Subjects
- Female, Humans, Male, Anti-Bacterial Agents therapeutic use, Drug Utilization statistics & numerical data, Inappropriate Prescribing statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Respiratory Tract Infections drug therapy
- Published
- 2015
- Full Text
- View/download PDF
9. Antibiotic prescribing for adults in ambulatory care in the USA, 2007-09.
- Author
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Shapiro DJ, Hicks LA, Pavia AT, and Hersh AL
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Drug Prescriptions standards, Drug Utilization standards, Female, Humans, Male, Middle Aged, United States, Young Adult, Ambulatory Care methods, Anti-Bacterial Agents therapeutic use, Drug Prescriptions statistics & numerical data, Drug Utilization statistics & numerical data
- Abstract
Objectives: To determine patterns of ambulatory antibiotic prescribing in US adults, including the use of broad-spectrum versus narrow-spectrum agents, to provide a description of the diagnoses for which antibiotics are prescribed and to identify patient and physician factors associated with broad-spectrum antibiotic prescribing., Methods: We used data for patients aged ≥ 18 years from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys (2007-09). These are nationally representative surveys of patient visits to offices, hospital outpatient departments and emergency departments (EDs) in the USA, collectively referred to as ambulatory visits. We determined the types of antibiotics prescribed, including the use of broad-spectrum versus narrow-spectrum antibiotics, and examined prescribing patterns by diagnoses. We used multivariable logistic regression to identify factors associated with broad-spectrum antibiotic prescribing., Results: Antibiotics were prescribed during 101 million (95% CI: 91-111 million) ambulatory visits annually, representing 10% of all visits. Broad-spectrum agents were prescribed during 61% of visits in which antibiotics were prescribed. The most commonly prescribed antibiotics were quinolones (25% of antibiotics), macrolides (20%) and aminopenicillins (12%). Antibiotics were most commonly prescribed for respiratory conditions (41% of antibiotics), skin/mucosal conditions (18%) and urinary tract infections (9%). In multivariable analysis, among patients prescribed antibiotics, broad-spectrum agents were more likely to be prescribed than narrow-spectrum antibiotics for respiratory infections for which antibiotics are rarely indicated (e.g. bronchitis), during visits to EDs and for patients ≥ 60 years., Conclusions: Broad-spectrum agents constitute the majority of antibiotics in ambulatory care. More than 25% of prescriptions are for conditions for which antibiotics are rarely indicated. Antibiotic stewardship interventions targeting respiratory and non-respiratory conditions are needed in ambulatory care.
- Published
- 2014
- Full Text
- View/download PDF
10. Antimicrobial stewardship education for medical students.
- Author
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Luther VP, Ohl CA, and Hicks LA
- Subjects
- Bacterial Infections microbiology, Drug Prescriptions standards, Health Policy, Humans, Anti-Bacterial Agents therapeutic use, Bacteria drug effects, Bacterial Infections drug therapy, Clinical Medicine education, Drug Resistance, Bacterial, Drug Utilization standards, Students, Medical
- Published
- 2013
- Full Text
- View/download PDF
11. More on U.S. outpatient antibiotic prescribing, 2010.
- Author
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Hicks LA, Taylor TH Jr, and Hunkler RJ
- Subjects
- Humans, Anti-Bacterial Agents therapeutic use, Drug Utilization statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data
- Published
- 2013
- Full Text
- View/download PDF
12. U.S. outpatient antibiotic prescribing, 2010.
- Author
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Hicks LA, Taylor TH Jr, and Hunkler RJ
- Subjects
- Humans, United States, Anti-Bacterial Agents therapeutic use, Drug Utilization statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data
- Published
- 2013
- Full Text
- View/download PDF
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