Changes in Antibiotic Prescribing Patterns in Danish General Practice during the COVID-19 Pandemic: A Register-Based Study

The World Health Organization expressed concern that antimicrobial resistance would increase during the COVID-19 pandemic due to the excessive use of antibiotics. This study aimed to explore if antibiotic prescribing patterns in general practices located in the North Denmark Region changed during the COVID-19 pandemic. The study was conducted as a registry-based study. Data was collected for every antibiotic prescription issued in general practices located in the North Denmark Region during the first year of the pandemic (1 February 2020 to 31 January 2021) and the year prior to the pandemic (1 February 2019 to 31 January 2020). Data were compared regarding antibiotic agents and the type of consultation linked to each antibiotic prescription. Results showed that antibiotic prescriptions decreased by 18.5% during the first pandemic year. The use of macrolides and lincosamides, along with combinations of penicillins and beta-lactamase -sensitive penicillins, was reduced the most. Face-to-face consultations related to an antibiotic prescription decreased by 28.5%, while the use of video consultations increased markedly. In Denmark, COVID-19 restrictions have contributed to both a lower consumption of antibiotics and a change in prescription patterns in general practice. Probably some of the COVID-19 -preventing initiatives could be of importance moving forward in the fight against antimicrobial resistance

Competences to self-manage low back pain among care-seeking adolescents from general practice - a qualitative study

BACKGROUND: There is limited knowledge about when and how adolescents with low back pain (LBP) interact with health care providers. This limits our understanding of how to best help these young patients. This study aimed to understand when and how care-seeking adolescents with LBP interact with health care providers and which health literacy competencies and strategies do they use to self-managing their LBP.METHOD: Ten semi-structured interviews (duration 20-40 min) were conducted online among adolescents aged 15-18 with current or recent LBP (pain duration range; 9 months - 5 years). The interview guide was informed by literature on health literacy and self-management in patients. We conducted a semantic and latent thematic data analyses.RESULTS: Three major themes emerged from the analysis: (1) Self-management, (2) Pain and Function, and (3) Communication. All adolescents were functionally limited by their pain but the main reason to consult a health care provider was an increase in pain intensity. Many were able to navigate the healthcare system, but experienced difficulties in communicating with health care providers, and many felt that they were not being taken seriously. Their first line self-management option was often over-the-counter pain medicine with limited effects. Most adolescents expressed a desire to self-manage their LBP but needed more guidance from health care providers.CONCLUSION: Adolescents with LBP seek care when pain intensifies, but they lack self-management strategies. Many adolescents want to self-manage their LBP with guidance from health care providers, but insufficient communication is a barrier for collaboration on self-management.</p

The pathway and characteristics of patients with non-specific symptoms of cancer:a systematic review

BACKGROUND: Non-specific symptoms are  common and often sign of a non-serious disease. Because of this, patients with non-specific symptoms of cancer (NSSC) present a challenge for general practitioners (GP). Studies describing characteristics of patients with NSSC have been done after fast-track pathways were created to diagnose and treat patients with NSSC. This study reviews characteristics of patients with NSSC and their patient pathways. MATERIALS AND METHODS: Database searches of Embase, Cochrane, PubMed, Cinahl and Web of Science were performed. Search terms used were cancer, patient pathway, and NSSC with their synonyms. The flow diagram Preferring Reporting Items for Systematic Review was applied to the systematic search. The Newcastle–Ottawa Assessment Scale (NOS) was used to compare the quality of the included studies. RESULTS: Twelve studies met the inclusion criterias. All studies were considered to be of high methodological quality. Patient Pathway: 11–35% of patients were diagnosed with cancer. Median number of days through diagnostic process was 7–10. Patient Characteristics: The most prevalent cancers included hematological-(14–30%), gastrointestinal-(13–23%) and lung cancers (13%). Rheumatological, musculoskeletal and gastrointestinal diseases were among the most common non-malignant diseases diagnosed. Weight loss, fatigue, pain and loss of appetite were the most common symptoms. Cardiovascular diseases, lung diseases, diabetes and previous diagnosed cancer were the most common comorbidities. Mean age of included patients was 60–72 years. CONCLUSION: Limited number of studies were found and they lacked sufficient heterogenic data to conduct a metaanalysis. Symptoms, diagnoses, age and gender were described with some heterogenic results. Further studies should be conducted to gather broader knowledge about patients with NSSC