Health Alliance for Prudent Prescribing, Yield and Use of Antimicrobial Drugs in the Treatment of Respiratory Tract Infections (HAPPY AUDIT)

BMC Family Practice

Study Protocol

Elena Egorova¹  Anatoliy Reutskiy¹  Ingvar Ovhed²  Sigvard Molstad²  Eva Lena Strandberg²  Ria Benko³  Vera Vlahovic-Palcevski³  Robert vander Stichele³  Lidia Caballero⁴  Walter von der Heyde⁴  Arnoldas Jurgutis⁵  Ruta Radzeviviene⁵  Dorte Jarboel⁶  Bente Gahrn-Hansen⁶  Anders Munck⁶  Malene Plejdrup Hansen⁶  Lars Bjerrum⁷  Silvia Hernández⁸  Carl Llor⁸  Josep Maria Cots⁸  Antoñia Pérez⁹  Beatriz González López-Valcárcel⁹  Marit Rønning^1,10  Christos Lionis^1,11 

[1] Association of Family Doctors, Kaliningrad, Russia;Department of Clinical Sciences, Lund University, Malmoe, Sweden;European Drug Utilisation Research Group, Ghent, Belgium;Misiones Association of General Family Medicine, Posadas, Argentina;Public Health Department, Klaipeda, Lithuania;Research Unit of General Practice, University of Southern Denmark, Odense, Denmark;Research Unit of General Practice, University of Southern Denmark, Odense, Denmark;The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;Spanish Society of Family Medicine, Barcelona, Spain;University of Las Palmas de Gran Canarias, Las Palmas, Spain;World Health Organisation, Collaborating Centre for Drug Statistics Methodology, Oslo, Norway;World Organisation of Family Doctors (WONCA), Lubljana, Slovenia;

关键词: Antibiotic Resistance;    Primary Health Care;    Bacterial Resistance;    Antibiotic Prescription;    Multifaceted Intervention;   

DOI  :  10.1186/1471-2296-11-29

 received in 2010-03-02, accepted in 2010-04-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundExcessive and inappropriate use of antibiotics is considered to be the most important reason for development of bacterial resistance to antibiotics. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries.The majority of respiratory tract infections (RTIs) are treated in general practice. Most infections are caused by virus and antibiotics are therefore unlikely to have any clinical benefit. Several intervention initiatives have been taken to reduce the inappropriate use of antibiotics in primary health care, but the effectiveness of these interventions is only modest. Only few studies have been designed to determine the effectiveness of multifaceted strategies in countries with different practice setting. The aim of this study is to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs) and patients in six countries with different prevalence of antibiotic resistance: Two Nordic countries (Denmark and Sweden), two Baltic Countries (Lithuania and Kaliningrad-Russia) and two Hispano-American countries (Spain and Argentina).Methods/DesignHAPPY AUDIT was initiated in 2008 and the project is still ongoing. The project includes 15 partners from 9 countries. GPs participating in HAPPY AUDIT will be audited by the Audit Project Odense (APO) method. The APO method will be used at a multinational level involving GPs from six countries with different cultural background and different organisation of primary health care. Research on the effect of the intervention will be performed by analysing audit registrations carried out before and after the intervention. The intervention includes training courses on management of RTIs, dissemination of clinical guidelines with recommendations for diagnosis and treatment, posters for the waiting room, brochures to patients and implementation of point of care tests (Strep A and CRP) to be used in the GPs'surgeries.To ensure public awareness of the risk of resistant bacteria, media campaigns targeting both professionals and the public will be developed and the results will be published and widely disseminated at a Working Conference hosted by the World Association of Family Doctors (WONCA-Europe) at the end of the project period.DiscussionHAPPY AUDIT is an EU-financed project with the aim of contributing to the battle against antibiotic resistance through quality improvement of GPs' diagnosis and treatment of RTIs through development of intervention programmes targeting GPs, parents of young children and healthy adults. It is hypothesized that the use of multifaceted strategies combining active intervention by GPs will be effective in reducing prescribing of unnecessary antibiotics for RTIs and improving the use of appropriate antibiotics in suspected bacterial infections.

【 授权许可】

CC BY   
© Bjerrum et al; licensee BioMed Central Ltd. 2010