Variations in Antibiotic Use in British Columbia

Project number: 
13-061
Approval date: 
Tuesday, March 18, 2014
Principal Investigator: 
McKay,Rachel
Institution: 
University of British Columbia (UBC)
Funding Agency: 
BC Centre for Disease Control (BCCDC)
Datasets requested: 
LifeLabs
PharmaNet
PharmaCare (BC Ministry of Health)
consolidation - census geocodes
MSP Practitioner File
Home and Community Care (BC Ministry of Health)
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
ACG Case Mix Group (Johns Hopkins University)
Hospital Separations (BC Ministry of Health)
Consolidation registry (Ministry of Health)
Research objective: 

1) The primary research questions are: Do detectable variations in antibiotic use exist? And, to what extent do patient, physician, and regional factors explain these variations?

Our secondary research questions are whether variations and their explanations differ by patient population groups, namely among children and the elderly, in particular elderly residents of long term care institutions.

2) We hypothesize that variations do exist in antibiotic prescribing in primary care, that patient factors contribute to this variation, and that physician factors contribute meaningfully as well. We hypothesize that there will be some variation between geographic areas, based primarily on indicators of accessibility of primary health care. In addition, we hypothesize that variations will differ between population groups, but that the determinants of variations will not differ substantially. Finally, we postulate that there will be greater variation in antibiotic prescribing for diagnoses associated with greater clinical uncertainty around specific diagnosis and etiology (eg. upper respiratory tract infections) than for diagnoses associated with greater clinical certainty (eg. urinary tract infections).

Publications: 

Journal Publication

  • McKay R, Law M, McGrail K, Balshaw R, Reyes R, Patrick DM (2019) What can we learn by examining variations in the use of urine culture in the management of acute cystitis? A retrospective cohort study with linked administrative data in British Columbia, Canada, 2005-2011. PLoS ONE 14(3): e0213534. https://doi.org/10.1371/journal.pone.0213534

    (This is the first version of research output #1861.)

  • McKay R, Law M, McGrail K, Balshaw R, Reyes R, Patrick DM (2019) What can we learn by examining variations in the use of urine culture in the management of acute cystitis? A retrospective cohort study with linked administrative data in British Columbia, Canada, 2005-2011. PLoS ONE 14(3): e0213534. https://doi.org/10.1371/journal.pone.0213534

Academic thesis or dissertation

  • McKay, R (2017). In search of improved approaches to antibiotic stewardship : can we explain variations in physician practice patterns related to outpatient infection management? (Doctoral dissertation). Retrieved from https://circle.ubc.ca/

Presentation of research material (poster/seminar/lecture etc.)

  • McKay, R (2017). In search of improved approaches to antibiotic stewardship : can we explain variations in physician practice patterns related to outpatient infection management? (Doctoral dissertation). Retrieved from https://circle.ubc.ca/

Page last revised: September 2, 2019