Over 30 million patient-level data and 20 million consultations from over 400 General Practices in England are used to reduce national and local burden of antimicrobial resistance (AMR).
Building Rapid Interventions to reduce antimicrobial resisTance and over-prescribing of antibiotics: (BRIT). To complement NHS Antibiotic Medicines Optimisation strategies, the BRIT project has generated novel insights into the use of antibiotics within the primary care landscape in the UK. A national DataLab has been established, containing more than 30 million patient-level records for the treatment of common infections in primary care. These data contain information on the consultation, the antibiotic prescriptions and are linked to hospital admission outcomes. A national antibiotic dashboard has been launched where information from over 20 million consultations has been analysed and made available in the form of a new digital dashboard, providing policy makers with access to detailed results of patient-level outcomes. GM CHC Care pathway For General Practices, BRIT has uniquely combined detailed analytics of very large national datasets (including anonymised data > 10 million patients) with deep analyses of the local practice data. This provides clinical teams with access to anonymised patient-level data that are analysed fortnightly with practice specific results fed back to improve clinical outcomes in their practice. BRIT has been established in almost 100 general practices with the required secure IT infrastructure for data processing and practice-specific feedback to support clinical decision-making. Why reduce antimicrobial resistance?
Around 32.5 million antibiotics are prescribed in England each year and antibiotic resistant infection costs the NHS £180m per year.
Research has found that the current use of antibiotics is highly variable across the NHS, resulting in the ineffective targeting of patients who are a high risk of infection related complications and emergency hospital admission. This has not improved within the past fifteen years.
Majority of hot spots with high rates of antibiotic prescribing are located in the North of England and were also typically more deprived than their ‘cold spot’ counterparts, specifically when factors such as income, employment, education, crime and health were taken into account.
Patients with frequent prior antibiotic use are more likely to suffer infection-related hospital admissions compared to those with limited prior antibiotic use. Suggesting repeated courses of antibiotics may have limited benefit and point toward adverse outcomes.
Starting in Autumn 2016, GM CHC in collaboration with the NHS and Public Health (North of England) designed a project to tackle variation and deliver advanced analytics to support the implementation of NHS antibiotic medicine optimisation strategies. New data driven insights into antibiotic prescribing patterns were published as part of the project such as prescribing non-opioid painkillers and benzodiazepines being strong indicators of the level of antibiotic prescribing within general practices. The BRIT infrastructure allows close to real time analyses and feedback of the effectiveness of quality improvement activities in each practice. With these in place, the team have established several successful collaborations with
First Databank to implement a decision support system,
Imosphere to offer their advanced user-friendly data analytics software to NHS users,
Apollo who deliver practice data securely into the TREs,
NICE DataLab to show how the application of advanced healthcare analytics can help demonstrate effectiveness of interventions to improve health outcomes with guidelines.
National Antibiotic Prescribing Dashboard The GM CHC team have developed a National Antibiotic Prescribing Dashboard which allows a range of health stakeholders, including policy makers, to better understand the factors that influence the UK’s antibiotic prescribing profile. The dashboard is being used nationally in the UK and internationally, with users logging on from North America, Brazil, Australia, India, The Philippines, Japan and countries within the European Union to view the standards being set in England. GP Antibiotic Prescribing Dashboard The GP dashboard uses anonymised health data to allow healthcare professionals in General Practice to compare their own antibiotic prescribing patterns with national and regional figures. Health care practitioners are also able to identify patients considered to be at high-risk of developing infection related complications, helping decisions on whether or not an antibiotic prescription is needed. Users get actionable insights into their practice based on advanced analytics, which summarise their own practice results and can be adapted to include further data analyses on request.