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Prescription Strategies in Acute Uncomplicated Respiratory Infections

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
1 policy source
twitter
221 tweeters
facebook
6 Facebook pages
googleplus
2 Google+ users

Citations

dimensions_citation
16 Dimensions

Readers on

mendeley
31 Mendeley
Title
Prescription Strategies in Acute Uncomplicated Respiratory Infections
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.

Twitter Demographics

The data shown below were collected from the profiles of 221 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 31 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 6 19%
Professor > Associate Professor 6 19%
Researcher 5 16%
Unspecified 3 10%
Student > Postgraduate 3 10%
Other 8 26%
Readers by discipline Count As %
Medicine and Dentistry 14 45%
Unspecified 5 16%
Social Sciences 3 10%
Nursing and Health Professions 2 6%
Agricultural and Biological Sciences 1 3%
Other 6 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 227. 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 27 January 2018.
All research outputs
#47,375
of 12,317,289 outputs
Outputs from JAMA Internal Medicine
#445
of 3,271 outputs
Outputs of similar age
#1,916
of 332,989 outputs
Outputs of similar age from JAMA Internal Medicine
#17
of 108 outputs
Altmetric has tracked 12,317,289 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 3,271 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 124.7. This one has done well, scoring higher than 86% 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 332,989 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 108 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.