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Prescription Strategies in Acute Uncomplicated Respiratory Infections: A Randomized Clinical Trial

Overview of attention for article published in JAMA Internal Medicine, January 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (84th percentile)

Mentioned by

news
9 news outlets
blogs
3 blogs
policy
4 policy sources
twitter
218 X users
facebook
6 Facebook pages
googleplus
2 Google+ users

Citations

dimensions_citation
71 Dimensions

Readers on

mendeley
195 Mendeley
Title
Prescription Strategies in Acute Uncomplicated Respiratory Infections: A Randomized Clinical Trial
Published in
JAMA Internal Medicine, January 2016
DOI 10.1001/jamainternmed.2015.7088
Pubmed ID
Authors

Mariam de la Poza Abad, Gemma Mas Dalmau, Mikel Moreno Bakedano, Ana Isabel González González, Yolanda Canellas Criado, Silvia Hernández Anadón, Rafael Rotaeche del Campo, Pere Torán Monserrat, Antonio Negrete Palma, Laura Muñoz Ortiz, Eulàlia Borrell Thió, Carl Llor, Paul Little, Pablo Alonso-Coello

Abstract

Delayed antibiotic prescription helps to reduce antibiotic use with reasonable symptom control. There are different strategies of delayed prescription, but it is not yet clear which one is the most effective. To determine the efficacy and safety of 2 delayed strategies in acute, uncomplicated respiratory infections. We recruited 405 adults with acute, uncomplicated respiratory infections from 23 primary care centers in Spain to participate in a pragmatic, open-label, randomized clinical trial. Patients were randomized to 1 of 4 potential prescription strategies: (1) a delayed patient-led prescription strategy; (2) a delayed prescription collection strategy requiring patients to collect their prescription from the primary care center; (3) an immediate prescription strategy; or (4) a no antibiotic strategy. Delayed prescription strategies consist of prescribing an antibiotic to take only if the symptoms worsen or if there is no improvement several days after the medical visit. The primary outcomes were the duration of symptoms and severity of symptoms. Each symptom was scored using a 6-point Likert scale (scores of 3 or 4 were considered moderate; 5 or 6, severe). Secondary outcomes included antibiotic use, patient satisfaction, and patients' beliefs in the effectiveness of antibiotics. A total of 405 patients were recruited, 398 of whom were included in the analysis; 136 patients (34.2%) were men; mean (SD) age, 45 (17) years. The mean severity of symptoms ranged from 1.8 to 3.5 points on the Likert scale, and mean (SD) duration of symptoms described on first visit was 6 (6) days. The mean (SD) general health status on first visit was 54 (20) based on a scale with 0 indicating worst health status; 100, best status. Overall, 314 patients (80.1%) were nonsmokers, and 372 patients (93.5%) did not have a respiratory comorbidity. The presence of symptoms on first visit was similar among the 4 groups. The mean (SD) duration of severe symptoms was 3.6 (3.3) days for the immediate prescription group and 4.7 (3.6) days for the no prescription group. The median (interquartile range [IQR]) of severe symptoms was 3 (1-4) days for the prescription collection group and 3 (2-6) days for the patient-led prescription group. The median (IQR) of the maximum severity for any symptom was 5 (3-5) for the immediate prescription group and the prescription collection group; 5 (4-5) for the patient-led prescription group; and 5 (4-6) for the no prescription group. Patients randomized to the no prescription strategy or to either of the delayed strategies used fewer antibiotics and less frequently believed in antibiotic effectiveness. Satisfaction was similar across groups. Delayed strategies were associated with slightly greater but clinically similar symptom burden and duration and also with substantially reduced antibiotic use when compared with an immediate strategy. clinicaltrials.gov Identifier: NCT01363531.

X Demographics

X Demographics

The data shown below were collected from the profiles of 218 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 195 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 <1%
United Kingdom 1 <1%
Spain 1 <1%
United States 1 <1%
Unknown 191 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 41 21%
Student > Master 22 11%
Other 18 9%
Student > Ph. D. Student 18 9%
Student > Bachelor 14 7%
Other 45 23%
Unknown 37 19%
Readers by discipline Count As %
Medicine and Dentistry 89 46%
Nursing and Health Professions 19 10%
Social Sciences 8 4%
Pharmacology, Toxicology and Pharmaceutical Science 7 4%
Agricultural and Biological Sciences 6 3%
Other 19 10%
Unknown 47 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 235. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2021.
All research outputs
#162,531
of 25,576,275 outputs
Outputs from JAMA Internal Medicine
#914
of 11,682 outputs
Outputs of similar age
#2,555
of 400,817 outputs
Outputs of similar age from JAMA Internal Medicine
#20
of 120 outputs
Altmetric has tracked 25,576,275 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,682 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 85.0. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 400,817 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 120 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 84% of its contemporaries.