Cargando…

Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study

BACKGROUND: The increase in the spread of antimicrobial resistance (AMR) in bacterial pathogens and limited availability of new antimicrobials places immense pressure on general practitioners (GPs) to prescribe appropriately. Currently, electronic antimicrobial prescribing data is not routinely coll...

Descripción completa

Detalles Bibliográficos
Autores principales: Galvin, Sandra, Callan, Aoife, Cormican, Martin, Duane, Sinead, Bennett, Kathleen, Murphy, Andrew W., Vellinga, Akke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489398/
https://www.ncbi.nlm.nih.gov/pubmed/26135455
http://dx.doi.org/10.1186/s12875-015-0280-3
_version_ 1782379351802642432
author Galvin, Sandra
Callan, Aoife
Cormican, Martin
Duane, Sinead
Bennett, Kathleen
Murphy, Andrew W.
Vellinga, Akke
author_facet Galvin, Sandra
Callan, Aoife
Cormican, Martin
Duane, Sinead
Bennett, Kathleen
Murphy, Andrew W.
Vellinga, Akke
author_sort Galvin, Sandra
collection PubMed
description BACKGROUND: The increase in the spread of antimicrobial resistance (AMR) in bacterial pathogens and limited availability of new antimicrobials places immense pressure on general practitioners (GPs) to prescribe appropriately. Currently, electronic antimicrobial prescribing data is not routinely collected from GPs in Ireland for surveillance purposes to assess regional specific fluctuations or trends in antimicrobial prescribing. The current study aimed to address this issue by assessing the feasibility of remotely extracting antimicrobial prescribing data from primary care practices in Ireland, for the purpose of assessing prescribing quality using the European Surveillance of Antimicrobial Consumption (ESAC) drug specific quality indicators. METHODS: Participating practices (n = 30) uploaded data to the Irish Primary Care Research Network (IPCRN). The IPCRN data extraction facility is integrated within the practice patient management software system and permitted the extraction of anonymised patient prescriptions for a one year period, from October 2012 to October 2013. The quality of antimicrobial prescribing was evaluated using the twelve ESAC drug specific quality indicators using the defined daily dose (DDD) per 1,000 inhabitants per day (DID) methodology. National and European prescribing surveillance data (based on total pharmacy sales) was obtained for a comparative analysis. RESULTS: Antimicrobial prescriptions (n = 57,079) for 27,043 patients were obtained from the thirty study practices for a one year period. On average, study practices prescribed a greater proportion of quinolones (37 % increase), in summer compared with winter months, a variation which was not observed in national and European data. In comparison with national data, study practices prescribed higher proportions of β-lactamase-sensitive penicillins (4.98 % vs. 4.3 %) and a greater use of broad spectrum compared to narrow-spectrum antimicrobials (ratio = 9.98 vs. 6.26) was observed. Study practices exceeded the European mean for prescribing combinations of penicillins, including β-lactamase inhibitors. CONCLUSIONS: This research demonstrates the feasibility and potential use of direct data extraction of anonymised practice data directly through the patient management software system. The data extraction methods described can facilitate the provision of routinely collected data for sustained and inclusive surveillance of antimicrobial prescribing. These comparisons may initiate further improvements in antimicrobial prescribing practices by identifying potential areas for improvement.
format Online
Article
Text
id pubmed-4489398
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-44893982015-07-03 Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study Galvin, Sandra Callan, Aoife Cormican, Martin Duane, Sinead Bennett, Kathleen Murphy, Andrew W. Vellinga, Akke BMC Fam Pract Research Article BACKGROUND: The increase in the spread of antimicrobial resistance (AMR) in bacterial pathogens and limited availability of new antimicrobials places immense pressure on general practitioners (GPs) to prescribe appropriately. Currently, electronic antimicrobial prescribing data is not routinely collected from GPs in Ireland for surveillance purposes to assess regional specific fluctuations or trends in antimicrobial prescribing. The current study aimed to address this issue by assessing the feasibility of remotely extracting antimicrobial prescribing data from primary care practices in Ireland, for the purpose of assessing prescribing quality using the European Surveillance of Antimicrobial Consumption (ESAC) drug specific quality indicators. METHODS: Participating practices (n = 30) uploaded data to the Irish Primary Care Research Network (IPCRN). The IPCRN data extraction facility is integrated within the practice patient management software system and permitted the extraction of anonymised patient prescriptions for a one year period, from October 2012 to October 2013. The quality of antimicrobial prescribing was evaluated using the twelve ESAC drug specific quality indicators using the defined daily dose (DDD) per 1,000 inhabitants per day (DID) methodology. National and European prescribing surveillance data (based on total pharmacy sales) was obtained for a comparative analysis. RESULTS: Antimicrobial prescriptions (n = 57,079) for 27,043 patients were obtained from the thirty study practices for a one year period. On average, study practices prescribed a greater proportion of quinolones (37 % increase), in summer compared with winter months, a variation which was not observed in national and European data. In comparison with national data, study practices prescribed higher proportions of β-lactamase-sensitive penicillins (4.98 % vs. 4.3 %) and a greater use of broad spectrum compared to narrow-spectrum antimicrobials (ratio = 9.98 vs. 6.26) was observed. Study practices exceeded the European mean for prescribing combinations of penicillins, including β-lactamase inhibitors. CONCLUSIONS: This research demonstrates the feasibility and potential use of direct data extraction of anonymised practice data directly through the patient management software system. The data extraction methods described can facilitate the provision of routinely collected data for sustained and inclusive surveillance of antimicrobial prescribing. These comparisons may initiate further improvements in antimicrobial prescribing practices by identifying potential areas for improvement. BioMed Central 2015-07-02 /pmc/articles/PMC4489398/ /pubmed/26135455 http://dx.doi.org/10.1186/s12875-015-0280-3 Text en © Galvin et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Galvin, Sandra
Callan, Aoife
Cormican, Martin
Duane, Sinead
Bennett, Kathleen
Murphy, Andrew W.
Vellinga, Akke
Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
title Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
title_full Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
title_fullStr Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
title_full_unstemmed Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
title_short Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
title_sort improving antimicrobial prescribing in irish primary care through electronic data collection and surveillance: a feasibility study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489398/
https://www.ncbi.nlm.nih.gov/pubmed/26135455
http://dx.doi.org/10.1186/s12875-015-0280-3
work_keys_str_mv AT galvinsandra improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy
AT callanaoife improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy
AT cormicanmartin improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy
AT duanesinead improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy
AT bennettkathleen improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy
AT murphyandreww improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy
AT vellingaakke improvingantimicrobialprescribinginirishprimarycarethroughelectronicdatacollectionandsurveillanceafeasibilitystudy