Antibiotic prescribing set to improve thanks to guide


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A Tasmanian initiative to provide a Quick Reference Guide to antibiotic prescribing in the community has been embraced by GPs and is set to improve prescribing, delegates at the National Medicines Symposium in Canberra have heard.

Recognising the growing problem of antibiotic resistance, and taking into account that around 80% of antibiotic prescribing occurs in community settings, where prescribing is less closely controlled, the project team identified an opportunity to improve access to guidelines for prescribers.

Angus Thompson from the University of Tasmania says that while there are excellent evidence based, comprehensive and well respected guidelines that have been developed for the Australian context, these guidelines are not freely available to all prescribers and are not tailored to meet the needs of GPs.

“Some guidelines for other therapy areas are freely available and produced in quick reference formats. We saw the opportunity to adapt the national antimicrobial prescribing guidelines to a similar style,” says Thompson.

The Quick Reference Guide is designed to support GPs in making more appropriate antibiotic prescribing decisions and some GPs are using the resource to engage patients in discussions about whether an antibiotic is needed and if it is, what is most appropriate.

“We know that around 70% of GPs who responded to a recent survey are already using the Quick Reference Guide, and they report that it has already had impacts on the choice of drug, dose, frequency and duration of treatment.

“The changes we’ve seen align well to best practice in antibiotic prescribing, including the MINDME antimicrobial prescribing creed.”

The project team is keen to see a community specific guideline template, similar to the Quick Reference Guide, developed nationally by key stakeholders and rolled out more widely, with local adaptation to account for local resistance patterns and the regional variations in the infections encountered by GPs.

“The national antimicrobial resistance strategy will take years to implement and will face many challenges, but our Quick Reference Guide to support evidence-based antimicrobial prescribing is one resource that could have an impact to improve practice in a much shorter time frame,” says  Thompson.

 

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4 Comments

  1. Debbie Rigby
    23/05/2016

    Sounds like a great resource. Can you please provide a link to it.

    • Angus Thompson
      24/05/2016

      Debbie, I would love to provide a link but we have some ‘issues’ to resolve with TG. These hampered us conducting a bigger study (we applied for a RACGP / TG grant last year) to evaluate the QRG which would have harvested data from GPs, Comm Pharms and a survey. My presentation last week led to some constructive dialogue with ‘can do’ people from TG and hopeully these ‘issues’ will be overcome.

  2. David Haworth
    23/05/2016

    “We know that around 70% of GPs who responded to a recent survey are already using the Quick Reference Guide, and they report that it has already had impacts on the choice of drug, dose, frequency and duration of treatment. Be nice to know if this was 70% of 40 GP’s or actually how many GP’s were surveyed. In rural Australia where many GP’s are overseas trained , default repeats are used and the default is that most patients fill the repeat.

    • Angus Thompson
      24/05/2016

      David, Our study was small (33 responses from 5 practices) and recognising this we applied for a grant to do a larger study, but were hampered by some ‘issues’ TG. Last week’s presentation was amongst other things, designed to get some traction to overcome the barriers to a wider roll out and evaluation. Despite the small size of the the local evaluation the results have been accepted for publication in the AJPH, recognising that adoption of better practice by even some GPs is desirable and may spread organically. Agree repeats is a big issue too – a study of ours on this is currently under consideration by JPPR

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