HAPPY AUDIT Seniorforskermøde maj 2008 [Kompatibilitetstilstand]

Lbjerrum

Description

ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒFør du går i gangGod ideGodt netværkHealth Alliance for Prudent Prescribing, Yield And Use of anti-i-mmicricrobial Drugs In the Treatment Tidof Respiratory Tract InfectionsPengeProposal for EU DG Research, March 2006Coordinator: Research Unit of General Practice, Odense, Denmark Distribution Distribution of focus for Antibiotika og resistensinfections in General PracticeBrug af antibiotika er den Skinvæsentligste faktor for 12% Bronchii11%selektion af resistente Lungsbakterier 7%90% af antibiotika EarsEyes8%8%11%orordidididinerneres es iiii a allllmen prmen praakkkkssiiiiss Respiratory TractSinuses60%12%60% af60% af orordinerdineretet Gyn Tonsilsantibiotika anvendes til 5% 17%luftvejsinfektioner OtherGI4%1%Størstedelen af Ur i n eluftvejsinfektioner skyldes 12%virusAntibiotika og resistensResistant StrainsRareAntimicrobial ExposureResistant Strains Dominant1ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒNetherlandsDenmarkSwedenGermanyAustriaUKreandI lGreeceItalyLuxemburgBelgiumPortugalSpainFranceUse of antibiotics in Europe in 1997DDD/1000 inhabitants/dayPenicillin-resistance (data based on drug sales)in pneumococci40353025Linear correlation between 20use of antibiotics and 15 resistance1050Broad-spectrum pc Narrow spectrum pc Penicillinase resistant pcCephalosporins Tetracyclins TrimethoprimQuinolones Macrolides Ot he r sFrom: Emerging Infectious Diseases 2004;19(3) ...

Informations

• Publié par: Dafeg
• Nombre de lectures: 31
• Langue: English

Extrait

H ealth A lliance for P rudent P rescribing, Y ield AndUse ofantimicrobial D rugs I n the T reatment of Respiratory Tract Infections

Proposal for EU DG Research, March 2006 Coordinator: Research Unit of General Practice, Odense, Denmark

Antibiotika og resistens

ƒ Brug af antibiotika er den væsentligste faktor for selektion af resistente bakterier ƒ 90% af antibiotika ormen praneres as s ƒ 60% af ordineret antibiotika anvendes til luftvejsinfektioner ƒ Størstedelen af luftvejsinfektioner skyldes virus

Antibiotika og resistens

Resistant Strains Rare

Antimicrobial Exposure

Resistant rans Dominant

Før du går i gang

ƒ God ide ƒ ƒ Tid ƒ Penge

Distribution of focus for infections in General Practice Skin Bronchii 11% Lungs 7% Ears E es 11 Respiratory Tract Sinuses 60% 12% Gyn Tonsils 5% 17% GI Other 1% 4% Urine 12%

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40 35 30 25 20 15 10 5 0

Use of antibiotics in Europe in 1997 DDD/1000 inhabitants/day (data based on drug sales)

Broadspectrum pc Cephalosporins Quinolones

Narrow spectrum pc Tetracyclins Macrolides

Penicillinase resistant pc Trimethoprim Others

Cars O et al: Variation in antibiotic use in the European Union. Lancet 2001, 357: 18513

Use of Quinolones in Europe

4.0 3.5 3.0 2.5

1.5 1.0 0.5 0.0

Thirdgeneration

Secondgeneration

Firstgeneration

Blue error bar represents the difference in national quinolone use in 2003 between ATC/DDD versions 2004 and 2003 due to the change of DDD for levofloxacine from 250 to 500 mg. * For Iceland total data are used; for Poland 2002 data are used.From: EARSS

HAPPY AUDIT Participation of 450 GPs from 12 regions 12

Local Noof Country Region artner GPs Denmark APOR 2 1 Funen100 Sweden BIRD 1 2 Blekinge50 3 Klaipeda30 Russia AFMK 4 Kaliningrad30 France CPMF 5 5 Paris30 Spain SEMFYC 6 Madrid30 7 Catalonia30 10 8 Valencia30 6 9 Andalusia30 7 10 Galicia30 11 Gran Canaria30 Ar entina 12 Missiones30 9 8 Total450

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Penicillinresistance in pneumococci

Linear correlation between resistance

From: Emerging Infectious Diseases 2004;19(3):514

HAPPY AUDIT Objective ƒ to reduce the occurrence of bacterial resistance ƒby reducing prescribing of unnecessary antibiotics for respiratory tract infections ƒby improving the use of appropriate antibiotics in suspected bacterial infections ƒby Improving the quality of diagnostic procedures for RTIs in general practice

How do we influence doctors to change their prescribing habits ? ƒ Written material ƒ Training courses ƒ Prescription feedback ƒ Reminders ƒ Academic detailing ƒ Audit interventions ƒ Guidelines combined with other initiatives ƒ Etc…

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The APO method: A simple and practical method for quality development in primary care

The Audit circle:

199293

Final courses and evaluation

FINAL CONFERENCE

SECOND REGISTRATION

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Second registration

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ems ion strategy

Courses

Reminders

Workshops

YTAPMONEMRTFINUDRLEATREETTILOTOSKPOIFNUD %001 fa%geriertsirnger %75 5 %0 52 % NormaltotPolaigks %0 O OT S K PO I DNUF nlmorauyrtrendlfevrukdaantdeubruiggel

Guidelinesrespiratory tract infections 1997 1995 1999

CONSENSUS CONFERENCE

STRATEGY CONFERENCE

TE R TTERv NEWSLETTERS

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30 20 10 0

Focus for respiratory infection

KickoffmeetingApril2007

Project time schedule

2007 X

2008 X

2009

2010

Analysis and conference

Second registration of Patients

Intervention: GPs and patients

First registration of Patients

First invitation of GPs

Total project period: 3 years (April 2007 – March 2010)

The consortium

Participant organisation nameShort nameCoun Type InterHealth Assoc. Re SME try nat.authority ofGPs search Research Unit for General Practice in OdenseRUPO DKGOV X GP ConsultantsGPC DKPRC X Ministry of the Interior and HealthMIH DKGOV X Blekinge Institute for Research and DevelopmentBIRD SEPNP X National Board of Health and WelfareNBHW SEGOV X FD CentreFDC LTPNP X State Patient FundSPF LTGOV X Association of Family Doctors, KaliningradAFMK RUPNP X College of Family Physicians in ParisCPMF FRPNP X Spanish Society of Family MedicineSEMFYC ESPNP X University of Las Palmas de Gran CanariaULPGC ESGOV X Consejería de Sanidad del Gobierno de CanariasCSGC ESGOV X Misiones Association of General Family Medicine andAMMeGeFES AR PNP X Health Team World Health Organisation, Collaborating Centre forWHOCC NOINO X X Drug Statistics Methodology World Organisation of Family DoctorsWONCA SIINO X XX European Drug Utilisation Research GroupEuroDURG BEINO X X

16 participants from 8 EU countries and 2 countries outside EU

WP2 Planning of Audit c cles

Audit implemen tation plan

Project structure

WP3 Development of Indicators

GP registration data

Audit guideline

WP10 Analysis of the audit results

Planning of audits and intervention

WP4 Intervention material for Patients

Intervention material for patients

WP5 Intervention for Professionals

Intervention material for professionals

WP6 APO cycles in the Nordic Region (2 APO cycles)

WP7 APO cycles in the Baltic Region (2 APO cycles)

WP8 APO cycles in France (1 APO cycle)

P9 APO cycles in HispanoAmerica (7 APO cycles)

Analysis and dissemination

Understanding the effect of intervention

WP11 valuation and working conference

Conclusions and recommendations

Dissemination

GP registration data

WP12 Preparing material for media campaigns

ƒ FollowupmeetingsforGPsineachregion ƒ HAPPY AUDIT Conference (month 36) ƒ Scientific publications and conference presentations ƒ Media campaigns targeting professionals and the public (to be financed by EU in separate projects)

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Time schedule

ƒ First partner meeting: October 2005 ƒ Submission to EU: March 2006 ƒ Evaluation by EU: July 2006 ƒ Project start: April 2007 * ƒ First registration: January 2008 * ƒ Second registration: January 2009 ƒ End of project: March 2010

* Plus 6 months for Argentina

Financing

EUcontribution: 1 Own financing : Totalprojectcost:

1,5million€ 08million€ 2,3million€

1 By contribution of permanent staff of the participants

Project time schedule

Work package WP1 Project Management WP2 Planning of audit cycles WP3 Development of indicators WP4 Intervention materials for Patients

Month 6 12 18 24 30 36

WP6 APO cycles in the Nordic Region (2 APO cycles) WP7 APO cycles in the Baltic Region (2 APO cycles) WP8 APO cycles in France (1 APO cycle) WP9 APO cycles in HispanoAmerica (6 APO cycles) WP10 Analysis of the audit results WP11 Evaluation and working conference WP12 Preparing material for media campaigns  M1M2 M3M4 M1 Guidelines for professionals completed Month 6 M2 Initial registration completed Month 13 M3 Intervention completed Month 21 M4 Workinconference comleted Month 35

Total project period: 3 years (20072009)

www.happyaudit.org

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Penicillin resistant pneumococci in Iceland 25 , 20 16,9 16,3 15 15 er cent 10 8,4 8,5 8,1 5 2,6 2,3 0 0 1988 1989 1990 1991 1992 1993 1994 1995 1997 2001 Year

”The more you use it, thefasteryouloseit”

Ref: Burke JP, Lancet 1995;345:977

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