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Chronic respiratory disease should be considered when interpreting indicators of community antimicrobial use in people over 65 years old.

ABSTRACT: OBJECTIVES:Chronic respiratory diseases (CRD) put patients at increased risk of respiratory infection and antimicrobial use, but surveillance results on community antimicrobial use are generally not adjusted for this risk factor. The objective of this study was to demonstrate the importance of accounting for CRD when interpreting indicators of community antimicrobial use in people over 65 years old, in Québec, Canada. METHODS:Retrospective cohort study of antimicrobial use according to CRD status in individuals over 65 years old covered by Québec's public drug insurance plan between 2010 and 2015. Defined daily doses per 1000 person-days (DID) were computed per antimicrobial class and were further stratified according to chronic disease group, fiscal year, gender and age group. RESULTS:Antimicrobial use was 2.3 times higher in the CRD group (29.7 DID) compared with the other chronic disease group (13.1 DID) and 3.1 times higher than in the no chronic disease group (9.6 DID). The same gradient was reflected as well in use per antimicrobial class, per age group, per gender, and in time. Antimicrobial use increased throughout the study period and was higher in older age groups and in women. CONCLUSIONS:Interpretation of results of antimicrobial use surveillance should consider the prevalence of CRD in populations. In order to identify opportunities for adapted interventions targeting inappropriate use, finer analyses are necessary.

SUBMITTER: Fortin E

PROVIDER: S-EPMC7351939 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Chronic respiratory disease should be considered when interpreting indicators of community antimicrobial use in people over 65 years old.

Fortin Élise É Jean Sonia S Sirois Caroline C Simard Marc M Irace-Cima Alejandra A Émond Valérie V Dionne Marc M

Canadian journal of public health = Revue canadienne de sante publique 20200114 3

<h4>Objectives</h4>Chronic respiratory diseases (CRD) put patients at increased risk of respiratory infection and antimicrobial use, but surveillance results on community antimicrobial use are generally not adjusted for this risk factor. The objective of this study was to demonstrate the importance of accounting for CRD when interpreting indicators of community antimicrobial use in people over 65 years old, in Québec, Canada.<h4>Methods</h4>Retrospective cohort study of antimicrobial use accordi ...[more]

PMID: 31939085

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Project description:Nowadays, various clinical scoring systems are used in the medical care of the elderly to assess the quality of mobility. However, people often tend to under- or overestimate themselves in many aspects. Since this can have serious consequences in their treatment and care, the aim of this study was to identify differences in the self and external assessment of mobility of persons over 65 years of age. 222 participants over 65 years of age and one external, closely-related relative or professional caregiver were interviewed by a unique study assistant using a standardized questionnaire. Participants were divided into people living in nursing homes and independent people living at home, where either the caregivers or the relatives provided the external assessment of mobility, respectively. The questionnaire included demographics, cognitive abilities (Mini Mental Status Test); fall risk (Hendrich 2 Fall Risk Model); as well as the Parker Mobility Score, Barthel Index, and EQ-5D-5L to measure mobility, activities of daily life and quality of life. In each case, the participant and the external person were asked for their assessment to the participants' mobility situation. Statistical significance of the difference between self and external assessment was calculated with a Wilcoxon rank-sum test and assumed with a p-value of ≤ 0.05. Self-assessment indicated a significantly higher value, when compared to an external assessment for the Parker Mobility Score for females in nursing homes (p ≤ 0.01), as well as for the Barthel Index for females (p ≤ 0.01) and males (p ≤ 0.01) in nursing homes. The EQ-5D-5L received a significantly higher self-assessment value for females (p ≤ 0.01) and males (p ≤ 0.01) living at home and females (p ≤ 0.01) and males (p ≤ 0.05) in nursing homes. Persons over 65 years of age tend to overestimate their level of mobility, quality of life and activities of daily life. Especially for people living in nursing homes, these scoring systems should be treated with caution due to the differences between the verbal statements. It is important to properly assess the mobility situation of elderly patients to ensure correct medical treatment and prevention of falls.

Dataset Information

Chronic respiratory disease should be considered when interpreting indicators of community antimicrobial use in people over 65 years old.

Publications

Chronic respiratory disease should be considered when interpreting indicators of community antimicrobial use in people over 65 years old.

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