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Seminar Outline

"Use of antibiotics - groundbreaking analysis from the new electronic prescription system." Kim Moylan HSC-BSO & Fiona Johnston NILS-RSU. Seminar Outline. Introduction to the HSC BSO: Data Available Enhanced Prescribing Data: Antibiotics Introduction to the NILS: Data Available

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Seminar Outline

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  1. "Use of antibiotics - groundbreaking analysis from the new electronic prescription system."Kim Moylan HSC-BSO & Fiona Johnston NILS-RSU

  2. Seminar Outline • Introduction to the HSC BSO: Data Available • Enhanced Prescribing Data: Antibiotics • Introduction to the NILS: Data Available • Distinct Linkage Project using the NILS &BSO • Preliminary Results • Next Steps

  3. Business Services Organisation Ophthalmic Family Practitioner Unit (FPS) Pharmaceutical Medical Information & Registration Unit Dental

  4. Dental Data: -Dentists & Associates -Patient Registrations & Treatments -Dental Payments Registration Data: -Patient Level information -Registered population -Immigration/Emigration -Internal Movement -GP Payments Data Available Pharmaceutical Data: -Prescription Cost analysis -Drug information -NEW Enhanced Prescription Information Ophthalmic Data: -Vouchers for Eye tests & Glasses -Opticians, Ophthalmic Surgeons & -Ophthalmic Payments

  5. Enhanced Prescribing Data 2-D barcode captures all information printed on the prescription, including prescribed drug data, plus some data not visible on the prescription Second 2-D barcode pre-printed on prescription gives GP information

  6. Unique individuals using/accessing Family Practitioner Services in 2009-10

  7. Current Data Examples

  8. Percentage People in receipt of drugs for treatment of bacterial infections Current Information

  9. Virus Body Invaders Fungus Parasite Bacteria

  10. Antibiotics

  11. Clostridium difficile (C Diff) THE 'NORMAL' GUT BACTERIA Lactobacilli Streptococci Clostridia Coliform Bacteriodes

  12. Methicillin-resistant Staphylococcus aureus (MRSA)

  13. Publicity on Inappropriate Antibiotic Prescribing

  14. Prescribing Patterns

  15. Prescribing Patterns

  16. Northern Ireland Longitudinal Study

  17. Distinct Linkage Projects (DLPs) • Potential to link to health and social services data for specially defined one-off studies; so far successfully linked to: • Breast Screening • Dental Activity • Prescribing • Legal and ethical scrutiny and privacy protection protocols • Database Linkage & Encryption Methodology

  18. EPD xyzb NILS NILS data at NISRA Prescribing data at HSC BSO Personal identifiers EPD Health & Care Number Health & Care Number NILS One-way encryption One-way encryption Removed Matching EPD xyzb xyzb NILS Removed EPD NILS Researcher access

  19. NILS-EPD Distinct Linkage Project Study Aims • Identify current antibiotic prescribing patterns by demographic & area characteristics. • Inform health policy & health research on management of antibiotics prescribing. Study Design • NILS members linked toantibiotic prescription data held on EPD, based on the 12 months ending May 2010 • Relationship between antibiotic prescriptions (incl. number of prescription items received) and: • individual demographic & socio-economic characteristics • area attributes • indicator for high (70% and over) and low coverage rates for scanned prescriptions • Descriptive analysis to look at patterns of prescription & regression analysis to test the relative importance of variables on usage.

  20. Prelim results: Descriptive Analysis – Population DistributionPrescriptions by Sex & Age

  21. Prelim results: Multinomial Logistic Regression – Relative RisksDemographic Factors: Age & Sex

  22. Prelim results: Multinomial Logistic Regression – Relative Risks Demographic Factors: Community Background & Marital StatusModels adjusted for Age & Sex

  23. Prelim results:Multinomial Logistic Regression – Relative RisksSocio-Economic Factors: Education & Tenure/Capital ValueModels adjusted for Age & Sex

  24. Preliminary analysis only! Next steps for analysis: more risk factors – variables to include family structure, self-reported health, socio-economic status (NSSEC and employment activity) comparison of high and low scan rates further analysis on impact of sex and older age groups area based analysis – settlement band, deprivation, sub-region establish optimal regression models establish optimal frequencies for antibiotic item groupings Desk research: over-prescribing & antimicrobial resistance lit. review Dissemination activities Next Steps

  25. The help provided by the staff of the Northern Ireland Longitudinal Study and the Northern Ireland Mortality Study (NILS and NIMS) and the NILS Research Support Unit is acknowledged. The NILS and NIMS are funded by the Health and Social Care Research and Development Division of the Public Health Agency (HSC R&D Division) and NISRA. The NILS-RSU is funded by the ESRC and Northern Ireland Government. The authors alone are responsible for the interpretation of the data. Acknowledgements

  26. HSC BSO Family Practitioner Services Website:www.hscbusiness.hscni.net/services/index.html NILS Research Support Unit Northern Ireland Statistics and Research Agency McAuley House Tel: 028 90 348138 Email:nils-rsu@qub.ac.uk Website:nils-rsu.census.ac.uk

  27. Frequencies Table

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