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Antibiotic Resistance and Medicinal Drug Policy

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Title: Antibiotic Resistance and Medicinal Drug Policy


1
Antibiotic Resistance and Medicinal Drug Policy
  • Dr. Ken HarveySchool of Public Health, La Trobe
    University,
  • Melbourne, Australia

1
2
Dr. Harveys visit to China was sponsored by
  • The World Health Organization
  • and hosted by Professor Yong-Hong Yang
  • Beijing Childrens Hospital
  • Professor Li Dakui
  • Peking Union Medical College

2
3
Lecture outline
  • Why the concern about antibiotic resistance?
  • The history, microbiological and social
    determinants of antibiotic resistance
  • Containing antibiotic resistance microbiological
    surveillance, antibiotic utilization studies and
    other interventions
  • One countrys response the quality use of
    medicines pillar of Australian drug policy
  • The current challenge using information
    technology to further improve antibiotic use

4
Therapeutic Guidelines Evaluation
  • Self-sufficiency was achieved (sales)
  • So was improved prescribing
  • De Santis G, Harvey KJ, Howard D, et al.
    Improving the quality of antibiotic prescribing
    in general practice the role of educational
    intervention. Med J Aust 1994 160 502-5.
  • Landgren FT, Harvey KJ, Mashford LM, et al.
    Changing antibiotic prescribing by educational
    marketing. Med J Aust 1988 149 595-599.
  • Harvey KJ. Quality assurance of therapeutic
    products and practice. Med J Aust 1987 147
    317.
  • Harvey KJ, Steward R, Hemming M, Moulds R.
    Antibiotic use in a large teaching hospital - the
    impact of antibiotic guidelines. Med J Aust 1983
    2217-221

(but only when guidelines were augmented by drug
audit, practitioner reflection and specific
change strategies)
5
Scaling up Australian National Drug Policy
6
Goals of medicinal drug policy
  • High quality products, introduced in a timely
    manner
  • Equity of access
  • Viable pharmaceutical industry
  • Quality of drug use

7
Goal Quality use of medicines
  • Purpose
  • to improve health outcomes by optimising
    medicinal drug use
  • Objectives
  • to improve the commitment of all players to QUM
    government, health professionals, industry and
    consumers
  • to increase the partnership between them

8
Quality use of medicines Strategies
  • Policy development and implementation
  • National facilitation and co-ordination
  • Objective information and ethical promotion
  • Education and training
  • Services and interventions
  • Data collection

9
Implementing quality use of medicines (QUM)
  • The Pharmaceutical Education Program (and the
    National Prescribing Service) have funds
    available. Projects could include
  • raising awareness of medicine use as a health
    issue
  • changing attitudes to the use of medicines
  • providing information to help people make
    informed decisions
  • highlight the alternatives to medicines use
  • monitor the good and bad effects of medicine
  • Scholarships are also available

10
QUM Objective information
11
Change strategies
11
12
http//www.qum.health.gov.au
13
QUM Policy Evaluation
14
QUM indicators Impact
15
QUM 2000 Strategy
To get Guidelines, medication review and other
proven QUM techniques off the library bookshelf...
...into day-to-day clinical decision making via
health workers computers
16
Internet a source of excellent information
http//www.healthsci.tufts.edu/APUA/apua.html
17
Australia incentives for computerization
18
QUMIT Decision support
19
Challenges E-conversion
20
Challenges E-Integration
21
Map clinical problem to a coded data
dictionary (ICPC2)
21
22
Map to PBS options
22
23
The Internet Connecting everyone
24
Conclusions
  • Increasing antibiotic resistance is a major
    threat to global public health
  • National (and international surveillance) of
    resistance patterns is crucial to guide therapy
    it also focuses the minds of clinicians,
    administrators and governments on the problem
  • Excessive and inappropriate use of antibiotics
    occurs in all countries this must be remedied at
    the national and local level
  • Best-practice antibiotic guidelines coupled with
    drug audits, and other strategies can improve
    antibiotic use.
  • The Internet and information technology holds
    promise for further improving prescribing in the
    future.

25
In short to contain antibiotic resistance
  • Old dogs need to learn new tricks

26
References on the Internet
  • WHO Report Overcoming Microbial Resistance
    http//www.who.int/multimedia/antibiotic_res/index
    .html
  • Australian Medicines Policy 2000
    http//www.health.gov.au/haf/docs/nmp2000.htm
  • Australian Quality Use of Medicines Site
    http//www.qum.health.gov.au/
  • Australian Therapeutic Guidelines
    http//www.tg.com.au/
  • Australian prescribing decision support project
    http//www-sph.health.latrobe.edu.au/telehealth/in
    dustry.htmElectronic
  • Australian and International Medicinal Drug
    Resources http//www-sph.health.latrobe.edu.au/Re
    sources/druginfo.htm
  • Australian HealthConnect Project
    http//www.health.gov.au/healthonline/welcome.htm

27
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