Diverticular disease management in primary care: How do estimates from community-dispensed antibiotics inform provision of care?

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dc.contributor.author Broad, Joanna en
dc.contributor.author Wu, Zhenqiang en
dc.contributor.author Ng, Jerome en
dc.contributor.author Arroll, Bruce en
dc.contributor.author Connolly, Martin en
dc.contributor.author Jaung, Rebekah en
dc.contributor.author Oliver, Frances en
dc.contributor.author Bissett, Ian en
dc.date.accessioned 2019-10-08T09:17:28Z en
dc.date.issued 2019-01 en
dc.identifier.citation PloS one 14(7):e0219818 Jan 2019 en
dc.identifier.issn 1932-6203 en
dc.identifier.uri http://hdl.handle.net/2292/48504 en
dc.description.abstract BACKGROUND:The literature regarding diverticular disease of the intestines (DDI) almost entirely concerns hospital-based care; DDI managed in primary care settings is rarely addressed. AIM:To estimate how often DDI is managed in primary care, using antibiotics dispensing data. DESIGN AND SETTING:Hospitalisation records of New Zealand residents aged 30+ years during 2007-2016 were individually linked to databases of community-dispensed oral antibiotics. METHOD:Patients with an index hospital admission 2007-2016 including a DDI diagnosis (ICD-10-AM = K57) were grouped by acute/non-acute hospitalisation. We compared use of guideline-recommended oral antibiotics for the period 2007-2016 for these people with ten individually-matched non-DDI residents, taking the case's index date. Multivariable negative binomial models were used to estimate rates of antibiotic use. RESULTS:From almost 3.5 million eligible residents, data were extracted for 51,059 index cases (20,880 acute, 30,179 non-acute) and 510,581 matched controls; mean follow-up = 8.9 years. Dispensing rates rose gradually over time among controls, from 47 per 100 person-years (/100py) prior to the index date, to 60/100py after 3 months. In comparison, dispensing was significantly higher for those with DDI: for those with acute DDI, rates were 84/100py prior to the index date, 325/100py near the index date, and 141/100py after 3 months, while for those with non-acute DDI 75/100py, 108/100py and 99/100py respectively. Following an acute DDI admission, community-dispensed antibiotics were dispensed at more than twice the rate of their non-DDI counterparts for years, and were elevated even before the index DDI hospitalisation. CONCLUSION:DDI patients experience high use of antibiotics. Evidence is needed that covers primary-care and informs self-management of recurrent, chronic or persistent DDI. en
dc.format.medium Electronic-eCollection en
dc.language eng en
dc.relation.ispartofseries PloS one en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Humans en
dc.subject Anti-Bacterial Agents en
dc.subject Population Surveillance en
dc.subject Primary Health Care en
dc.subject Disease Management en
dc.subject New Zealand en
dc.subject Female en
dc.subject Male en
dc.subject Diverticular Diseases en
dc.title Diverticular disease management in primary care: How do estimates from community-dispensed antibiotics inform provision of care? en
dc.type Journal Article en
dc.identifier.doi 10.1371/journal.pone.0219818 en
pubs.issue 7 en
pubs.begin-page e0219818 en
pubs.volume 14 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 777176 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Gen.Practice& Primary Hlthcare en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
pubs.org-id Surgery Department en
dc.identifier.eissn 1932-6203 en
pubs.record-created-at-source-date 2019-07-18 en
pubs.dimensions-id 31314796 en


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https://creativecommons.org/licenses/by/4.0/ Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/
https://creativecommons.org/licenses/by/4.0/ Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/

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