Wed, 2020/11/18 - 9:16am
Open Access Means Better Antibiotic Stewardship
The University of Guelph’s Ontario Veterinary College (OVC) is leading the charge globally in antibiotic stewardship as the central hub for the veterinary component of a new antibiotic stewardship platform.
The website, Open Stewardship [www.openasp.org], will serve as an access point for veterinarians and primary care doctors to understand better their prescribing patterns.
Open Stewardship is currently in use by pilot groups of community-based doctors in Canada and Israel. Pilot groups of veterinarians in both countries will begin using the platform in winter 2021. (Interested veterinarians can learn more at www.mathepilab.org/open).
This information will shed light on local antibiotic use patterns and such knowledge will be helpful in trying to reduce antibiotic resistance. It will promote appropriate antibiotic prescribing among medical practitioners by using individual feedback and benchmarking of their prescribing practices.
This process in which feedback drives change has been successful in previous human initiatives and Prof. Amy Greer and postdoctoral fellow Dr. Kamal Acharya from OVC’s Department of Population Medicine, are hoping that it will be successful in the veterinary world as well. Greer is a key member of this international initiative along with collaborators with the University of Toronto, Public Health Agency of Sweden and Ben-Gurion University in Israel.
“Antibiotic resistance is a rising global concern for public health,” says Greer. “The ultimate goal for this tool is to empower medical professionals from any country, looking at any species, to understand and improve their prescribing practices by providing them with tailored, regional feedback.”
Here’s how the pilot study will work. After inputting their prescription records for three months, participants receive a report on their antibiotic prescription writing – specifically, how their activity compares to their peers (such as other doctors in the practice) and where they rank. Feedback reports also include information on clinical best practice guidelines, including appropriate dosages and context-specific guidelines.
Overall, the report will give users an indication of where they fall on the prescribing spectrum so that they can make appropriate changes if necessary, and give researchers an idea of whether there are regional and country-specific patterns influencing prescribing.
“Antibiotics are used in both animals and people and so all medical professionals should be reflecting on their prescribing habits as a way to help to reduce global antibiotic resistance,” says Greer. “This research uses a One Health approach because we understand that humans, animals and the environment all play a role in the occurrence of antibiotic resistance. It’s important to improve prescribing across all sectors and to support one another.”
Interested medical practices (both human and veterinary) will be able to use the online platform once the study intervention trials are complete and the website platform becomes public, likely in 2021. Although the platform will be public, medical practices will remain anonymous while using the website tool and still receive individual feedback. Everyone will be able to view geographic patterns.
“We don’t want to improve antimicrobial stewardship top-down,” says Greer. “There is so much value in local context and this new website allows tailored feedback based on region and/or practice group. There’s been a lot of supporting research saying that direct feedback helps facilitate change – we hope that by making Open Stewardship open access, medical practices will elect to use it to deliver stewardship interventions to their members in order to improve appropriate prescribing.”
Collaborators on this international initiative include Drs. Derek MacFadden and David Fisman from the University of Toronto, Drs. Sonja Lofmark and Annette Huth from the Public Health Agency of Sweden, and Drs. Nadav Davidovitch and Moriah Ellen from Ben-Gurion University in Israel.
Funding for this research is provided by the Joint Programming Initiative in Antimicrobial Resistance, The Canadian Institutes for Health Research, The Swedish Research Council and the Israel Ministry of Health.
This article originally appeared in the Summer 2020 issue of The OVC Crest, the research, teaching and health care magazine of the Ontario Veterinary College.