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Following Welsh model could cut antibiotic use, says report.

ALMOST 1.6 million "unnecessary" prescriptions for antibiotics could be prevented if all GPs adopted a new Welsh model, research has suggested.

A major research project, involving 68 GP practices in Wales, found enabling doctors to discuss treatment options with their patients prevented antibiotics being prescribed inappropriately for such conditions as coughs and sinusitis.

The findings of the Cardiff University research come amid rising concern about the problem of antibiotic resistance. Experts and leading doctors have spoken of their fears of a return to a pre-antibiotic era - before the advent of penicillin - when people suffered or died from bacterial infections that were untreatable.

It has been estimated between 20% and 50% of anti-microbial use in hospitals and in the wider community is inappropriate.

The Cardiff University Star - Stemming the Tide of Antimicrobial Resistance - programme was specifically designed to cut the number of unnecessary antibiotic prescriptions.

Led by Professor Chris Butler, the two-year trial involved 68 practices covering some 480,000 patients in Wales. It offered GPs access to unique antibiotic prescribing and resistance data drawn from their own practices and advanced "consulting skills" tools.

The learning tools, the result of more than 15 years of work in infections and communication sciences by members of the Institute of Primary Care and Public Health team at Cardiff University, were designed to enable GPs to discuss treatment options more effectively with their patients.

It also gave GPs access to online learning materials, and allowed them the flexibility to learn and try out the new skills with their patients at times that were convenient.

Prof Butler said: "Antibiotic resistance remains one of the most important public health issues of our time, with antibiotic prescribing driving up resistance.

"As most antibiotics are prescribed in general practice, safely reducing the number of unnecessary prescriptions is essential.

"The Star programme helped Welsh GPs gain new skills derived from motivational interviewing so they could achieve evidence-based treatment, while taking patient perspectives into account.

"Although the percentage reduction in antibiotic prescribing was fairly small, based on national population estimates, if the findings of this study were replicated across Wales this would imply a reduction of well over 78,000 dispensed oral antibiotic items per year, and if replicated across the UK, a reduction of over 1.6 million dispensed oral antibiotic items per year."

The study, done in conjunction with the South-East Wales trials unit and published in the British Medical Journal, resulted in fewer oral antibiotics being dispensed for a whole year for practices where GPs had undergone Star training. And it found that patients in the Star practices did not experience detectable increases in complications, hospital admissions, re-consultation rates, or costs associated with fewer antibiotics.
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Publication:Western Mail (Cardiff, Wales)
Geographic Code:4EUUK
Date:Feb 10, 2012
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