avoidable antibiotic use in acute bronchitis
TRANSCRIPT
AVOIDABLE ANTIBIOTIC USE IN
ACUTE BRONCHITIS
Julio Porro, MD
Central California Alliance for Health – Medical Director
AAB: HEDIS Measure
Clinical Review
Resources
Summary
TODAY’S AGENDA
HEDIS MEASURE
Technical Specifications
The % of adults 18-64 years of with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription at initial diagnosis
Health Plans:
Quality Measure
Self-limited upper airway infection with cough as the primary symptom
Infection causes inflammation of cells lining the bronchi
A virus is the causative pathogen in ≥90% of cases
ACUTE BRONCHITIS
Common condition
~12 million cases per year in US
60-90% of patients seek care for acute bronchitis are treated with an antibiotic
ACUTE BRONCHITIS
PATIENT MANAGEMENT
Inappropriate use of antibiotics is a significant
public health problem
In patients with severe symptoms, rule out more severe conditions (e.g., pneumonia)
Consider differential diagnosis: Upper respiratory infection (URI)
Sinusitis
Tuberculosis
Pertussis
Asthma
Pneumonia
Pharyngitis
PATIENT MANAGEMENT
Patient Demand
Most patients want a diagnosis, not necessarily antibiotics
Messaging:
Most bronchitis is a viral illness, and coughs are either viral or reactive airway disease
Antibiotics may have serious side effects and may create resistance to antibiotics in the patient or their family
PATIENT MANAGEMENT
PATIENT MANAGEMENT
Helpful Tips:
Set appropriate expectations for duration of symptoms
Give symptomatic relief such as: Codeine-based cough suppressants,
NSAIDS,
Multi-symptom OTC medications, and
Possibly bronchodilators if there is any bronchospasm
Caution patients regarding symptoms (such as high fevers and shortness of breath) that indicate more severe disease
Reserve antibiotics for patients with acute bacterial exacerbation of chronic bronchitis and COPD
Test prior to or in conjunction with treatment for pertussis
PATIENT MANAGEMENT
PATIENT RESOURCES: CDC
Website: https://www.cdc.gov/antibiotic-use/community/for-hcp/outpatient-hcp/index.html
Material Messages:
“Antibiotics Aren’t Always the Answer”
“Be Antibiotics Aware: Smart Use, Best Care”
Print Materials:
Antibiotic Prescribing Material
Antibiotic Resistance Education
English & Spanish Material
PATIENT RESOURCES: CDC
ALLIANCE RESOURCES
Provider Educational Materials Available:
Guideline summary
Adult and pediatric compendia
Provider tools:
AAB HEDIS Tip Sheet
CDC Healthcare Professional Resources
Provider Portal Report
ALLIANCE RESOURCES CONTINUED
Cold & Flu Rx Pad Prescription pads available
for your clinic Double-sided English &
Spanish Customize to include
medications/treatment If no improvement include
number of days to follow up with you
PATIENT & PROVIDER EDUCATION STRATEGIES
Display posters for awareness to avoid antibiotics if not necessary
Share literature regarding avoidance of antibiotics in acute bronchitis
SUMMARY
Diagnosis of bronchitis antibiotics
CDC resources & messaging
Patient management
Patient & provider education strategies
QUESTIONS? CONTACT INFORMATION:
(831) 430-2622