{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:23:49Z","timestamp":1787009029907,"version":"build-2736575974"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T00:00:00Z","timestamp":1692921600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012068","name":"Health and Care Research Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012068","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physician\u2013nurse task shifting, a process of delegation whereby tasks are moved to other specialized healthcare workers, is used in primary care in many countries to improve access, efficiency and quality of care. One such task is the prescription of medicines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify nurse independent prescriber (NIP) and GP numbers in England, the proportions and types of NIP and GP antibiotic prescriptions dispensed in the community, and the impact of COVID-19 on the volume, rate and types of antibiotic prescriptions dispensed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Descriptive population-based retrospective cohort study using routinely collected data on prescriptions for antibiotics dispensed in the community in England between January 2014 and October 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2014 and 2021, numbers (headcount) of NIPs whose prescriptions were dispensed in the community rose by 146% to 34\u200a997. GP numbers (headcount) rose by 10% to 44\u200a681. Of the 25.373 million antibiotic prescriptions dispensed between 2014 and 2021, NIPs were responsible for 8.6%. The rate of dispensed antibiotic prescriptions per prescriber per calendar year decreased (by 50% for NIPs and by 21% for GPs) between 2014 and 2020. This decreasing trend continued following the onset of the COVID-19 pandemic across both groups. Narrow-spectrum antibiotics (penicillins, macrolides, tetracyclines) were the most frequently dispensed across both NIPs and GPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NIPs are an increasing contributory influence on total antibiotic prescribing and should be included in antimicrobial stewardship efforts. Interventions for this group need to be tailored to the population and context in which they work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkad267","type":"journal-article","created":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T16:45:32Z","timestamp":1692117932000},"page":"2544-2553","source":"Crossref","is-referenced-by-count":13,"title":["Patterns of GP and nurse independent prescriber prescriptions for antibiotics dispensed in the community in England: a retrospective analysis"],"prefix":"10.1093","volume":"78","author":[{"given":"Molly","family":"Courtenay","sequence":"first","affiliation":[{"name":"School of Healthcare Sciences, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Centre for Trials Research, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Lim","sequence":"additional","affiliation":[{"name":"Reading School of Pharmacy, University of Reading , Reading , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,25]]},"reference":[{"key":"2023100302092899400_dkad267-B1","author":"CDDEP","year":"2015"},{"key":"2023100302092899400_dkad267-B2","author":"WHO","year":"2019"},{"key":"2023100302092899400_dkad267-B3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/2042098614554919","article-title":"Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem","volume":"5","author":"Llor","year":"2014","journal-title":"Ther Adv Drug Saf"},{"key":"2023100302092899400_dkad267-B4","first-page":"629","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"399","author":"Antimicrobial resistance collaborators","year":"2019","journal-title":"Lancet"},{"key":"2023100302092899400_dkad267-B5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-051983","article-title":"Antimicrobial stewardship and infection prevention interventions targeting healthcare-associated Clostridioides difficile and carbapenem-resistant Klebsiella pneumoniae infections: a scoping review","volume":"11","author":"Okeah","year":"2021","journal-title":"BMJ Open"},{"key":"2023100302092899400_dkad267-B6","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.ijnurstu.2014.11.014","article-title":"Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?","volume":"52","author":"Freund","year":"2015","journal-title":"Int J Nurs Stud"},{"key":"2023100302092899400_dkad267-B7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3399\/bjgp14X676960","article-title":"The future shape of primary care","volume":"64","author":"Roland","year":"2014","journal-title":"Br J Gen Pract"},{"key":"2023100302092899400_dkad267-B8","author":"NHS England","year":"2016"},{"key":"2023100302092899400_dkad267-B9","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1111\/1475-6773.12425","article-title":"Comparing the cost of care provided to Medicare 366 beneficiaries assigned to primary care nurse practitioners and physicians","volume":"51","author":"Perloff","year":"2016","journal-title":"Health Serv Res"},{"key":"2023100302092899400_dkad267-B10","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.ijnurstu.2007.07.013","article-title":"What is the impact of advanced primary care nursing roles on patients, nurses and their colleagues? A literature review","volume":"45","author":"Bonsall","year":"2008","journal-title":"Int J Nurs Stud"},{"key":"2023100302092899400_dkad267-B11","first-page":"530","article-title":"Comparing the cost of nurse practitioners and GPs in primary care: modelling economic data from randomised trials","volume":"56","author":"Hollinghurst","year":"2006","journal-title":"Br J Gen Pract"},{"key":"2023100302092899400_dkad267-B12","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1136\/bmj.324.7341.819","article-title":"Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors","volume":"324","author":"Horrocks","year":"2002","journal-title":"BMJ"},{"key":"2023100302092899400_dkad267-B13","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-007167","article-title":"Cost-effectiveness of nurse practitioners in primary and specialised ambulatory care: systematic review","volume":"5","author":"Martin-Misener","year":"2015","journal-title":"BMJ Open"},{"key":"2023100302092899400_dkad267-B14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12960-015-0049-8","article-title":"The impact of physician\u2013nurse task shifting in primary care on the course of disease: a systematic review","volume":"13","author":"Mart\u00ednez-Gonz\u00e1lez","year":"2015","journal-title":"Hum Resour Health"},{"key":"2023100302092899400_dkad267-B15","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1177\/1077558715586297","article-title":"Task-shifting from physicians to nurses in primary care and its impact on resource utilization: a systematic review and meta-analysis of randomized controlled trials","volume":"72","author":"Mart\u00ednez-Gonz\u00e1lez","year":"2015","journal-title":"Med Care Res Rev"},{"key":"2023100302092899400_dkad267-B16","article-title":"The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review","volume":"145","author":"Mart\u00ednez-Gonz\u00e1lez","year":"2015","journal-title":"Swiss Medical Wkly"},{"key":"2023100302092899400_dkad267-B17","author":"Department of Health","year":"2001"},{"key":"2023100302092899400_dkad267-B18","author":"PHE","year":"2021"},{"key":"2023100302092899400_dkad267-B19","author":"UK Health Security Agency","year":"2022"},{"key":"2023100302092899400_dkad267-B20","author":"Department of Health and Social Care","year":"2019"},{"key":"2023100302092899400_dkad267-B21","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1093\/jac\/dkx230","article-title":"Patterns of dispensed non-medical prescriber prescriptions for antibiotics in primary care across England: a retrospective analysis","volume":"72","author":"Courtenay","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2023100302092899400_dkad267-B22","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jhin.2019.02.019","article-title":"Tackling antimicrobial resistance 2019\u20132024: the UK\u2019s five-year national action plan","volume":"101","author":"Courtenay","year":"2019","journal-title":"J Hosp Infect"},{"key":"2023100302092899400_dkad267-B23","author":"PHE","year":"2020"},{"key":"2023100302092899400_dkad267-B24","author":"Health Education England"},{"key":"2023100302092899400_dkad267-B25","article-title":"Nurses as substitutes for doctors in primary care","volume":"7","author":"Laurant","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2023100302092899400_dkad267-B26","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1080\/13814788.2021.1954616","article-title":"Task shifting in primary care to tackle healthcare worker shortages: an umbrella review","volume":"27","author":"Leong","year":"2021","journal-title":"Eur J Gen Pract"},{"key":"2023100302092899400_dkad267-B27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-029177","article-title":"Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B","volume":"9","author":"Courtenay","year":"2019","journal-title":"BMJ Open"},{"key":"2023100302092899400_dkad267-B28","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1093\/jac\/dkx429","article-title":"General practitioner and nurse prescriber experiences of prescribing antibiotics for respiratory tract infections in UK primary care out-of-hours services (the UNITE study)","volume":"73","author":"Williams","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"2023100302092899400_dkad267-B29","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1177\/0141076820931452","article-title":"The primary care response to COVID-19 in England\u2019s National Health Service","volume":"113","author":"Majeed","year":"2020","journal-title":"J R Soc Med"},{"key":"2023100302092899400_dkad267-B30","doi-asserted-by":"crossref","first-page":"e166","DOI":"10.3399\/BJGP.2020.0948","article-title":"Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study","volume":"71","author":"Murphy","year":"2021","journal-title":"Br J Gen Pract"},{"key":"2023100302092899400_dkad267-B31","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S1473-3099(20)30917-8","article-title":"Antibiotic prescribing in general practice during COVID-19","volume":"21","author":"Armitage","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"2023100302092899400_dkad267-B32","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1001\/2013.jamainternmed.305","article-title":"A comparison of care at e-visits and physician office visits for sinusitis and urinary tract infection","volume":"173","author":"Mehrotra","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2023100302092899400_dkad267-B33","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.3390\/antibiotics10121531","article-title":"Impact of the COVID-19 pandemic on community antibiotic prescribing and stewardship: a qualitative interview study with general practitioners in England","volume":"10","author":"Borek","year":"2021","journal-title":"Antibiotics"},{"key":"2023100302092899400_dkad267-B34","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1017\/ice.2020.1233","article-title":"Reduction in ambulatory visits for acute, uncomplicated bronchitis: an unintended but welcome result of the coronavirus disease 2019 (COVID-19) pandemic","volume":"42","author":"Dilworth","year":"2021","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2023100302092899400_dkad267-B35","author":"NHS England","year":"2018"},{"key":"2023100302092899400_dkad267-B36","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1186\/s12889-020-09227-x","article-title":"An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England","volume":"20","author":"Thomson","year":"2020","journal-title":"BMC Public Health"},{"key":"2023100302092899400_dkad267-B37","author":"NICE","year":"2015"},{"key":"2023100302092899400_dkad267-B38","author":"NICE","year":"2019"},{"key":"2023100302092899400_dkad267-B39","author":"NICE","year":"2023"},{"key":"2023100302092899400_dkad267-B40","author":"NICE","year":"2017"},{"key":"2023100302092899400_dkad267-B41","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2020.103787","article-title":"Nurse role and contribution to antimicrobial stewardship: an integrative review","volume":"117","author":"Gotterson","year":"2021","journal-title":"Int J Nurs Stud"},{"key":"2023100302092899400_dkad267-B42","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jhin.2022.07.010","article-title":"Influences on nurses\u2019 engagement in antimicrobial stewardship behaviours: a multi-country survey using the Theoretical Domains Framework","volume":"129","author":"Chater","year":"2022","journal-title":"J Hosp Infect"},{"key":"2023100302092899400_dkad267-B43","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.jhin.2019.08.001","article-title":"Development of consensus based international antimicrobial stewardship competencies for undergraduate nurse education","volume":"103","author":"Courtenay","year":"2019","journal-title":"J Hosp Infect"},{"key":"2023100302092899400_dkad267-B44","doi-asserted-by":"crossref","first-page":"e633","DOI":"10.3399\/bjgp18X697889","article-title":"Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography","volume":"68","author":"Germeni","year":"2018","journal-title":"Br J Gen Pract"},{"key":"2023100302092899400_dkad267-B45","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implement Sci"},{"key":"2023100302092899400_dkad267-B46","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-028326","article-title":"A theory-based electronic learning intervention to support appropriate antibiotic prescribing by nurses and pharmacist: intervention development and feasibility protocol","volume":"9","author":"Courtenay","year":"2019","journal-title":"BMJ Open"},{"key":"2023100302092899400_dkad267-B47","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-036181","article-title":"Theory-based electronic learning intervention to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers: an acceptability and feasibility experimental study using mixed methods","volume":"10","author":"Lim","year":"2020","journal-title":"BMJ Open"},{"key":"2023100302092899400_dkad267-B48","author":"RCGP"},{"key":"2023100302092899400_dkad267-B49","author":"PHE"},{"key":"2023100302092899400_dkad267-B50","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1111\/jan.14170","article-title":"The prescribing needs of community practitioner nurse prescribers: a qualitative investigation using the theoretical domains framework and COM-B","volume":"75","author":"Chater","year":"2019","journal-title":"J Adv Nurs"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/10\/2544\/51743433\/dkad267.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/10\/2544\/51743433\/dkad267.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T22:10:40Z","timestamp":1696284640000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/78\/10\/2544\/7251193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,25]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,8,25]]},"published-print":{"date-parts":[[2023,10,3]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkad267","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,10]]},"published":{"date-parts":[[2023,8,25]]}}}