HAPPY AUDIT Seniorforskermøde maj 2008 [Kompatibilitetstilstand]
6 pages

HAPPY AUDIT Seniorforskermøde maj 2008 [Kompatibilitetstilstand]


Le téléchargement nécessite un accès à la bibliothèque YouScribe
Tout savoir sur nos offres


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) ...



Publié par
Nombre de lectures 31
Langue English
HealthAlliance forPrudentPrescribing,Yield AndUseofantimicrobialDrugsIn theTreatment of Respiratory Tract Infections
Proposal for EU DG Research, March 2006 Coordinator: Research Unit of General Practice, Odense, Denmark
Antibiotika og resistens
ƒBrug af antibiotika er den væsentligste faktor for selektion af resistente bakterier ƒ90% af antibiotika ormen praneres as s ƒ60% af ordineret antibiotika anvendes til luftvejsinfektioner ƒStørstedelen af luftvejsinfektioner skyldes virus
Antibiotika og resistens
Resistant Strains Rare
Antimicrobial Exposure
Resistant rans Dominant
Før du går i gang
ƒGod ide ƒƒTid ƒPenge
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%
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
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 entina12 Missiones30 9 8 Total450
Penicillinresistance in pneumococci
Linear correlation between resistance
From: Emerging Infectious Diseases 2004;19(3):514
HAPPY AUDIT Objective ƒto 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 ? ƒWritten material ƒTraining courses ƒPrescription feedback ƒReminders ƒAcademic detailing ƒAudit interventions ƒGuidelines combined with other initiatives ƒEtc…
The APO method: A simple and practical method for quality development in primary care
The Audit circle:
Final courses and evaluation
G :P AUDTI:ReipsarotyrIfnceitonsinGeneralPartccie0210 ta ct Con T py e foonectiInftnbioiitAgniaDcdnasisoetCertifica fmor contactkcislevae etrtematn I n cf te oi n of uc sofantiChoiceibtocis rtaettnemriogin o yln 1 x o1lynoxylnx1oyn1lxx13oylnx1.nm1im.xa7xoynlx1Nmueorbcfonlusoitatsndoty:a
eRg:etadnoitartsi 0 1 DeatofBtihres x dayomhtn1 26 10112226178192115171 ey ra 3 4529879816232512423022214033132 33eR kam sr 1 2 3 4 5 6 7 8 9 01 11 12 13 14 15 latoT % CpoigyrA:htudiPrtkejoOtesnediW,nswløpkaer19n5000nedODCs,eK
Second registration
PG : AUIDR:TsepriatroynIfetcisnoGnirenePlaractice2001 oeypTfisosndaDngaiciotintibAnoIfnceitC re tacifit e efnItcifnocousC ioh c oe naf bt ii io ct s cat t noC  tcatnoc(sickleave) rof m etartemntoirnigrtaemttne oyln1xynox1lno1ylx1x3onlyx1mi1n.axm7.xolny1x only 1 x uNorebmnocfuottialsdtsona:y
geRtirsiadnota:te 0 1 D foeta B htrixse adymtohnyear 1 23 456 7 8 9 101120216118291152137111418293627222323532233204R me skra 1 2 3 4 5 6 7 8 9 10 11 21 31 41 51 Ttaol % CoprPtiduA:thgiryoW,seOtdekjensniølpwekran915000eOndseC,KD
ems ion strategy
YTAPMONEMRTFINUDRLEATREETTILOTOSKPOIFNUD %001 fa%geriertsirnger %75 5 %0 52 % NormaltotPolaigks %0 O OT S K PO I DNUF nlmorauyrtrendlfevrukdaantdeubruiggel
Guidelinesrespiratory tract infections 1997 1995 1999
30 20 10 0
Focus for respiratory infection
Project time schedule
2007 X
2008 X
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 DKGOVX GP ConsultantsGPC DKPRCX Ministry of the Interior and HealthMIH DKGOVX Blekinge Institute for Research and DevelopmentBIRD SEPNPX National Board of Health and WelfareNBHW SEGOVX FD CentreFDC LTPNPX State Patient FundSPF LTGOVX Association of Family Doctors, KaliningradAFMK RUPNPX College of Family Physicians in ParisCPMF FRPNPX Spanish Society of Family MedicineSEMFYC ESPNPX University of Las Palmas de Gran CanariaULPGC ESGOVX Consejería de Sanidad del Gobierno de CanariasCSGC ESGOVX Misiones Association of General Family Medicine andAMMeGeFES AR PNPX Health Team World Health Organisation, Collaborating Centre forWHOCC NOINOX X Drug Statistics Methodology World Organisation of Family DoctorsWONCA SIINOX XX European Drug Utilisation Research GroupEuroDURG BEINOX 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
GP registration data
WP12 Preparing material for media campaigns
ƒFollowupmeetingsforGPsineachregion ƒHAPPY AUDIT Conference (month 36) ƒScientific publications and conference presentations ƒMedia campaigns targeting professionals and the public (to be financed by EU in separate projects)
Time schedule
ƒFirst partner meeting: October 2005 ƒSubmission to EU: March 2006 ƒEvaluation by EU: July 2006 ƒProject start: April 2007 * ƒFirst registration: January 2008 * ƒSecond registration: January 2009 ƒEnd of project: March 2010
* Plus 6 months for Argentina
EUcontribution: 1 Own financing :Totalprojectcost:
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 completedMonth 6 M2 Initial registration completedMonth 13 M3 Intervention completedMonth 21 M4 Workinconference comletedMonth 35
Total project period: 3 years (20072009)
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