title: The antibiotic prescription and redemption gap and opportunistic CRP point-of-care testing. A cross-sectional study in primary health care from Eastern Austria.
abstract: OBJECTIVE
  The aim of this study was to analyse the frequency of C-reactive protein (CRP) rapid test use by general practitioners (GPs), the role of the test in the antibiotic treatment decisions and the efficacy of the test in a primary care setting, with special emphasis on the redemption rate of antibiotic prescriptions.
  
  
  METHODS
  For this cross-sectional study, GPs documented their CRP test use for 2.5 years. In addition, demographic and the antibiotic prescription and redemption data of the patients were documented. Three groups were clustered according to the three possible CRP test results (1: < 10 mg/l, 2: 10-30 mg/l, 3: > 30 mg/l); analyses were conducted by using descriptive statistical methods and tests.
  
  
  RESULTS
  Thirty GPs documented 692 initial CRP tests. The antibiotic prescription rate was 9.2 % for the first, 71.7 % for the second and 98.7 % for the third group (p < 0.001). A difference between the patients of the three CRP groups according to the redemption rate of antibiotic prescriptions (30.8 vs. 62.7 vs. 64.0 %; p = 0.013) could be found, with the lowest rate in the first group. Overall, 16.3 % of the patients filled an antibiotic at a pharmacy that was not in accordance with the CRP test result documentation form.
  
  
  CONCLUSIONS
  The CRP test results show an association with both the antibiotic prescribing and redemption behaviour. Noticeable was the antibiotic redemption behaviour of the patients: 36 % of patients with a CRP test result over 30 did not fill the antibiotic prescribed which is an important finding related to patients adherence and of special interest due to the fact that none of these patients had a hospital admission afterwards. On the contrary, nearly one-fifth of the patients who did not get an antibiotic in connection with the CRP test result finally filled an antibiotic prescription.
authors: Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalg. 15/1st floor, 1090 Vienna, Austria. kathryn.hoffmann@meduniwien.ac.at
authors: Kathryn
authors: K
authors: Hoffmann
authors: Anna Katharina
authors: AK
authors: Leifheit
authors: Berthold
authors: B
authors: Reichardt
authors: Manfred
authors: M
authors: Maier
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis*; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D055656:Prescriptions / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein