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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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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 |
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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 |
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