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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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antibioticdayNovember 6 2015

Experts agree that single consistent message is vital to changing patient behaviour of antibiotic usage

 

  • Ahead of Antibiotics Awareness Day on 18th November 2015, experts at a pivotal, multi-disciplinary meeting on antibiotic resistance agreed that a single consistent message, conveyed by HCPs, is key to educating patients about over-prescribing
  • RB hosted an antibiotic stewardship meeting involving high level specialists to tackle unnecessary antibiotic use in primary care with ‘Call to Action’ report to follow
  • Patient demands for antibiotics from GPs and under-used pharmacists are key out-takes from a new GP and Pharmacists survey presented at meeting
  • Antimicrobial resistance is listed on the National Risk Register and expected to kill around 10 million people a year globally, by 2050


Multi-disciplinary experts convene at antibiotic stewardship meeting to tackle unnecessary antibiotic prescribing
A high level, multidisciplinary Antibiotic Stewardship meeting “WHAT’S THE ALTERNATIVE?”, held on 6th October 2015, brought together leading experts from the GP and pharmacy community and academics from professional bodies to collectively tackle over-prescribing of antibiotics. The meeting, organised and funded by RB, manufacturers of sore throat brand Strefen, and the Global Respiratory Infection Partnership* (GRIP), saw experts debate the issue of antibiotic resistance, share best practice and develop solutions to help reduce unnecessary use of antibiotics in primary care.   


Desire for a simple, single message to be communicated
Attendees concluded that a single consistent message driven by HCPs to patients is pivotal to helping relieve the pressure they put on GPs to prescribe unnecessary antibiotics. There was consensus on the importance of better education regarding the likely duration of symptoms of upper respiratory tract infections (URTIs), coupled with good advice on symptom management with over-the-counter (OTC) medicines, as the appropriate alternative to antibiotics that can’t tackle cold and flu viruses.
 
Also, these specialists agreed that greater collaboration amongst HCPs was fundamental in helping tackle patient demands and over-prescribing. A ‘Call to Action’ report sharing findings from the meeting will follow later in the year to encourage greater collaboration and raise awareness of best practice initiatives that will drive greater and faster change in the wider healthcare community.
 
Experts in attendance, including Leyla Hannbeck, Chief Pharmacist from the National Pharmacy Association; John Smith, Chief Executive of PAGB; Dr Paul Edmondson-Jones, Director of Public Health for Redcar and Cleveland Borough Council; Professor Rob Darracott, CEO of Pharmacy Voice; and Professor Jane Portlock, Professor of Pharmacy Practice have all implemented programmes in this area, and supported other initiatives such as GRIP and European Antibiotics Awareness Day, to help raise awareness and determine change (see note to editors for full list of attendees). Whilst such initiatives have made great progress and achieved measurable outcomes, it was a single message that the experts believed will bring together all the current efforts on driving change and help achieve greater collaboration amongst HCPs, whilst empowering patients towards self-care.
 
Meeting Chair, Dr Martin Duerden, GP and Clinical Advisor on prescribing and evidence-based medicine for the RCGP said, “We already know that this is a major concern with Government firmly committed to tackling it, but we still see a relentless growth in the demand for, and the prescribing and overuse of antibiotics. This is why meetings such as these are crucial to developing collaborative and coordinated strategies to help address this escalating issue. Healthcare professionals, particularly pharmacists, who are ideally placed to interact with patients early on, must unite in order to facilitate change.”
 
Adrian Shephard, Senior Global Professional Relations Manager at RB comments,  “By bringing together leading experts who have spearheaded initiatives around antibiotic resistance and stewardship, we hope to avoid duplication in effort and look for opportunities to collaborate and cross-promote to make all our efforts go further.”
 
Pharmacists under-utilised resource for antibiotic stewardship
 
In 2015, NICE introduced the first guidelines on antimicrobial stewardship highlighting the seriousness of monitoring the use of antibiotics. New research shows over half (61%) of pharmacists surveyed agreed that antibiotic stewardship is a high priority, however just under half (46%) said they have no measures in place to tackle it. Four in five (83%) pharmacists would like to see more training available to help them effectively undertake this role. Experts at the meeting agreed that pharmacists are well placed to provide antibiotic stewardship but remain under-used. The research echoed this fact with three quarters (74%) of pharmacists claiming to be under-utilised. However, an important proportion of those surveyed agreed that they should take more of a role in providing advice to patients on why antibiotics are not effective for most RTIs (79%), educate patients on self-care (78%), work more closely with GPs (75%) and provide alternative treatment options (67%).
 
“Upper respiratory tract infections are a common pharmacy enquiry and the consensus amongst pharmacists is that antibiotics are not the answer and measures should be taken to monitor their use before it is too late”, says Leyla Hannbeck from the National Pharmacy Association. “Pharmacists are in a great position to educate patients on appropriate antibiotic use, provide self-care advice and recommend treatment options with OTC medicines. Not only will this empower patients to take more of a self-care approach, but it will also reduce patient demands on GPs for antibiotics.”

antibiotic guardian

Patient education key to reducing pressure on GPs

GPs report that the RTIs they receive the most requests for antibiotics from their patients include acute sore throat, pharyngitis and tonsillitis (40%) followed by acute coughs and bronchitis (30%) and acute otitis media (22%). Unsurprisingly 69% of pharmacists believe patient pressure to be the main contributor to unnecessary or ineffective antibiotic prescribing, whilst 13% saw GP consultation time constraints as responsible. Patients’ limited understanding of URTIs and their incorrect belief that antibiotics will treat their symptoms were also cited as contributing factors in the meeting. The experts agreed that many of these issues could be remedied through the availability of comprehensive resources to educate patients. These would be used to encourage a more patient centric approach to healthcare by driving patients to use pharmacists more, whilst a separate campaign targeting GPs could help inform them of the proactive role pharmacists can play therefore reducing pressure on GPs to prescribe antibiotics.
 
John Smith, Chief Executive of PAGB concluded: “A key driver to help reduce demands on GPs is to empower people to self-care, seeking advice from a pharmacist if needed. Research shows that 52 million GP appointments a year are for minor ailments, such as coughs and colds, symptoms that can be treated effectively with OTC medicines. A big problem is that people don’t understand that antibiotics don’t treat viruses. We need one clear consistent message, from Government, the NHS and healthcare professionals, to encourage people to self-care and drive them back into pharmacy to seek more suitable treatments for their symptoms.”
 
Dr Cathal Coyle, Professional Relations Manager at RB said, “We all have a responsibility to do our bit including industry and RB is committed to supporting efforts to reduce inappropriate antibiotic prescribing. Helping patients understand the underlying cause of their illness, the likely duration of their symptoms and the ability to self-treat with OTC medication is key. RB is working with leading experts, organisations, the HCP community and the general public towards finding and implementing solutions to help achieve this goal.”
 
Antimicrobial resistance: a high priority

Antimicrobial resistance is a high priority on the public health agenda with pressure on policy makers to introduce strategies to address the issue. In 2013, Chief Medical Office, Dame Sally Davies announced the five year strategy to champion better use of antibiotics and strengthen surveillance of their use whilst in 2015 antimicrobial resistance escalated to the National Risk Register of Civil Emergencies  alongside pandemic influenza and terrorist attacks, as an emerging and long term issue. Also a review was commissioned by the Prime Minister in 2014 exploring the development of new antibiotics and how best to encourage innovative thinking and research in order to change methods for treating infectious diseases. Recommendations are expected in 2016.
 
Antimicrobial resistance is expected to kill about 10 million people a year around the world by 2050. Currently 25,000 people in Europe already die each year as a result of antibiotic resistant bacteria whilst healthcare costs and productivity amount to a staggering €1.5b.

Links:

Antibiotic Guardian

EAAD Website

Antibiotic awareness resources: 2015

GRIP Initiative

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