Study examines overall ARI antibiotic prescribing at clinics
NEW YORK — As a growing fraction of acute respiratory infections visits occur at retail-based health clinics, researchers examined the impact of the shift to such clinics and found that, compared with primary care practices and emergency rooms, there was no difference at retail clinics in overall ARI antibiotic prescribing, according to a study published online in The American Journal of Managed Care.
“In prior studies comparing rates of antibiotic prescribing, little difference was observed between retail clinics and outpatient physician practices; however, these were small studies that used a limited set of diagnoses and health plan claims data,” researchers stated. ”In this study, we compared antibiotic prescribing at retail clinics, primary care practices, and emergency departments (EDs) for all ARIs using national data collected directly from the EHR or the medical chart.”
Researchers found that between 2007 and 2009, there were 3 million, 162 million, and 29 million ARI visits, respectively, at retail clinics, primary care practices, and EDs. There were several notable differences in patient characteristics across the three care sites. Children and adolescents made up a smaller fraction of ARI visits to retail clinics (27%) than to primary care practices (50%) and EDs (43%). A smaller fraction of patients reported a chronic illness at retail clinics (4%) compared with primary care practices (20%) and EDs (22%).
The study also found that the mix of ARI visits varied by site of care. At retail clinics, a higher proportion of ARI visits (53%) led to an antibiotics-may-be-appropriate diagnosis (sinusitis, otitis media, and streptococcal pharyngitis) than at primary care physician offices (32%) and EDs (29%).
“In a large, nationally representative sample of ARI visits, retail clinics had an antibiotic prescribing rate similar to that of primary care practices and EDs. This is reassuring evidence that the shift in care to retail clinics will not negatively impact antibiotic prescribing in the United States. The lack of a difference is consistent with the larger literature, that demonstrates that nurse practitioners and physicians provide care of similar quality,” researchers stated.
According to researchers, ARIs account for 60% of all retail clinic visits. Providers at retail clinics independently manage and prescribe medications. State regulations vary on whether nurse practitioners at retail clinics must maintain a collaborative or supervisory relationship with a physician. Currently, there are almost 6 million yearly visits to the 1,600 retail clinics in the United States, and the number of retail clinics is expected to grow rapidly in the coming years.
Several U.S. retailers take part in Earth Day 2015
NEW YORK — Wednesday marked the 45th anniversary of Earth Day ― a day intended to inspire awareness and appreciation for the Earth's natural environment. Since its inception, the movement has sparked a vast outpouring of support and this year was no exception.
Joining many groups around the globe, several U.S. retailers stepped up to the plate to celebrate Earth Day 2015. Some of the highlights include:
• Giant Eagle celebrated Earth Day this year with a commitment to reduce water consumption by 5% by July 2017, resulting in an anticipated conservation of millions of gallons of water.
• For four consecutive years, Publix Super Markets has celebrated Earth Day with a $40,000 contribution to Sustainable Fisheries Partnership totaling $160,000. This year's project is focused on improving the conditions associated with shrimp aquaculture. The donation will fund research to improve fisheries and help shrimp aquaculture in southeast Asia become more sustainable. Other sustainable efforts include the company's commitment to reusable shopping bags.
• Kroger, which was recently recognized by the U.S. EPA for its efforts to reduce food waste, has launched a microsite — Kroger.com/earthday — to inspire customers to live green, save money and reduce waste at home.
• Each year, the “ShopRite Earth Day Challenge” challenges volunteers to beautify their communities by cleaning up litter and restoring local parks and beaches. In 2014, approximately 6,000 volunteers – wearing donated gloves and using donated trash bags from ShopRite — gathered to clean up 63 communities in Connecticut, Delaware, Maryland, New Jersey, New York, and Pennsylvania.
The first Earth Day on April 22, 1970, activated 20 million Americans from all walks of life and is widely credited with launching the modern environmental movement. Today, more than 1 billion people now participate in Earth Day activities each year, making it the largest civic observance in the world, according to the Earth Day Network.