Evaluation of the Do Bugs Need Drugs? Spring; 2. 2(1): 1. Telephone 6. 04- 7. M. lehca. RCopyright . All rights reserved. This article has been cited by other articles in PMC. Abstract. OBJECTIVE: Antibiotic resistance is accelerated by the overuse of antibiotics. The current article presents a descriptive evaluation of the impact of the program over the first four years. METHOD: Program implementation was measured by the amount of educational material distributed and the level of participation in educational sessions. The impact of the program was assessed by measuring changes in knowledge and prescribing habits of participating physicians, and by investigating provincial trends in antibiotic use. RESULTS: A total of 5. Pre- and postcourse assessments of participating physicians indicated significant improvements in clinical knowledge and appropriate antibiotic treatment of upper respiratory tract infections. Overall rates of antibiotic use in the province have stabilized since 2. The rates of consumption of fluoroquinolones and macrolides have levelled off since 2. Utilization rates for acute bronchitis are at the same level as when the program was first implemented, but rates for other acute upper respiratory tract infections of interest have declined. CONCLUSIONS: The Do Bugs Need Drugs? Les taux globaux d’utilisation des antibiotiques dans la province se sont stabilis. Statistics and drug utilization. Publications authored by CHSPR faculty and staff from. The University of British Columbia; The Bridge Program; Home. BRITISH COLUMBIA AND ITS. TO THE HONOURABLE SINDI HAWKINS MINISTER OF HEALTH. I THE REFERENCE DRUG PROGRAM The British Columbia Pharmacare program. Responsible drug disposal program. Community Drug Utilization Program Vancouver, BC Roula Tzianetas MSc Candidate University of British Columbia. British Columbia Community Drug Utilization Program (CDUP) British Columbia Pharmacy Association (BCPhA) Canadian. See also Pharmacy Organizations on Bing. Community Health Programs, British Columbia Ministry of Health and Ministry Responsible for. Drug Utilization/statistics & numerical. Effects of Provincial Drug PLan Eligibility on Prescription Drug Utilization among Ontario and British. Trends in antibiotic utilization associated with the “do bugs need drugs?” program in british columbia by elaine isabelle fuertes b.sc., (honours) queen’s. Leurs taux d’utilisation pour la bronchite aigu? The increasing prevalence and geographical spread of resistant and multiresistant organisms threatens this progress (2–5). Antibiotic resistance is a naturally occurring biological phenomenon, but has been exacerbated by selective pressure caused by the use and misuse of antimicrobials (6–9). Ecological studies and randomized controlled trials (6,7,1. It has been estimated that antibiotic use is unnecessary or inappropriate in up to 5. United States and Canada (1. Infection control practices, hospital formulary policies and immunization programs have important roles to play in the containment of antimicrobial resistance (1. Such activities should take into account known drivers of prescribing including patient knowledge and expectation, and physician time pressure (1. Large- scale campaigns promoting the optimization of antibiotic use have been implemented in many jurisdictions. Ecological data (2. Overall, such programs have proven to be most effective when they target both public and health care providers (1. In the fall of 2. British Columbia (BC) adopted the Do Bugs Need Drugs? The DBND program aims to reduce the number of unnecessary antibiotic prescriptions by educating the public and health care professionals on the appropriate use of antibiotics, primarily focusing on acute upper respiratory tract infections. The main objective of the present article is to describe the progress and evaluation of the DBND program from September 1, 2. August 3. 0, 2. 00. An analysis of the time series antibiotic prescribing data is presented elsewhere (2. The goal of the evaluation is to measure both process and outcomes associated with the program. The process evaluation comprises the number of participants in each arm of the program, the distribution of print material and the reach of the media campaign. Outcome evaluation includes measuring public knowledge and attitudes, and monitoring overall antibiotic consumption, class- specific antibiotic consumption and indication- specific antibiotic consumption. METHODSThe present article describes an ecological study of the association between implementation of the DBND program and population outcome indicators. There were two main arms of the DBND program: the public component and the health care professional education component, both of which were implemented in phases. The public education component included annual media campaigns, print material distribution, and audience- specific education curricula targeting children in daycare (two to five years of age) and their parents, grade 2 students (seven years of age) and their parents, older adults in assisted- living facilities and the general public. The print material included signs, posters, stickers, activity placemats and a parent’s guide to managing common infections. The media campaigns were aired on television and radio, and advertising appeared on transit routes and vehicles. The key messages delivered by each of these means were identical. Wash your hands. Antibiotics work against bacteria, not against viruses. Use antibiotics wisely because bacteria can become resistant to them. Participation in the daycare, grade 2 and assisted- living programs was recorded by the trainers and submitted to DBND. Inventory logs were maintained to track the distribution of print material, and reports were provided by the transit and media contractors, which use industry- standard methodologies to estimate the reach of these initiatives. A telephone survey was conducted by Ipsos Reid (Canada) before and after the initial launch of the program to assess knowledge and attitudes regarding the program’s key messages. The objective of the public education component was to promote the key messages in an effort to improve hand hygiene behaviours and to reduce patient pressure, which can affect prescribing decisions of physicians. The health care professional education arm of the program offered accredited courses to physicians and pharmacists, with a focus on antibiotic use, resistance and strategies to prescribe appropriately. Physicians and pharmacists who participated in the accredited continuing education programs completed pre- and postcourse learner assessments. These assessed general knowledge of resistance trends, etiology of respiratory infections and treatment options. Physicians also completed four indication- specific quizzes before and after participation in the course. These quizzes were not identified, so they could not be statistically compared before and after. Physicians completed carbon- copy prescription pads for one month preceding and one month following participation in the course. These prescription pads were used with every patient presenting with upper respiratory tract symptoms, and recorded diagnosis, nonantibiotic symptomatic recommendations, antibiotic treatment and known drug allergies. The top copy was given to the patient as a valid script, while the bottom copy (not containing identifying information) was returned to the DBND program for evaluation purposes. In addition, health care providers, and health care and early childhood education students, were trained to deliver the public education sessions. The objectives of the health care professional education arm of the program were to promote the key messages, specifically, to reduce antibiotic prescriptions for acute bronchitis and acute otitis media; to reduce the use of fluoroquinolones and newer macrolides (azithromycin and clarithromycin); and to reduce the overall use of antibiotics in the population. A detailed description of the program components was beyond the scope of the present article. Contact the authors for further information or visit < dobugsneeddrugs. Antibiotic consumption. BC Pharma. Net is a provincial network that links community- based BC pharmacies to a central data system. Pharma. Net provides real- time information about all prescription medications dispensed to an individual in BC, and allows pharmacists to quickly identify and warn about potentially harmful medication interactions. In 2. 00. 7, more than 4. The Pharma. Net data include all prescriptions dispensed via retail or online pharmacies in BC, with the exclusion of bulk purchases by general practitioners and purchases for veterinary use. The database contains a study identifier, age, sex and drug information detailing generic name, brand name, form, strength and quantity dispensed, date of dispensing and the practitioner identifier. An anonymized data extract from Pharma. Net was obtained from 1. DBND program. Each dispensing record was then matched to the Medical Services Plan (MSP) billing system, which represents physician services remunerated on a fee- for- service basis, and includes The International Classification of Diseases – Ninth Revision diagnostic codes. The matching criteria were study identifier, practitioner identifier and the date of dispensing within five days after the date of physician service. If more than one MSP record met the matching criteria, the record with the closest date to the date of dispensing was used. Multiple MSP records due to different diagnostic codes for the same date of service were counted as separate indications for the drug dispensed. Antimicrobials were classified according to the WHO’s 5- level Anatomical Therapeutical Chemical (ATC) classification system (2. Only oral prescriptions for J0. Consumption was further broken down into six major ATC classes: J0. A (tetracyclines), J0. C (beta- lactam penicillins), J0. D (other beta- lactam), J0. E (sulfonamides/trimethoprim), J0. F (macrolides) and J0. M (quinolones). For the MSP- matched records, the diagnostic codes were regrouped into specific indications of interest. Data were aggregated by year for each major ATC class and/or each redefined indication. Antibiotic consumption rates were expressed in defined daily doses (DDD) per 1. BC Health Data Warehouse’s Population Extrapolation for Organizational Planning with Less Error (P. E. O. P. L. E.). This method has been reported previously (2. Information on the overall cost of antimicrobials paid by BC residents, and by the government, was obtained from the Pharmaceutical Services Division of the BC Ministry of Health Services. Ethics review was granted by the University of British Columbia (Vancouver, British Columbia) for the linkage of physician billing and prescription data. Completion of the learner assessments and prescription pads were part of the program’s accreditation agreement. Statistical methods. Most of the results presented in the current study are descriptive.
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