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"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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Presentation Transcript
slide1
"Use of antibiotics - groundbreaking analysis from the new electronic prescription system."Kim Moylan HSC-BSO & Fiona Johnston NILS-RSU
seminar outline
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
business services organisation

Business Services Organisation

Ophthalmic

Family Practitioner Unit (FPS)

Pharmaceutical

Medical

Information & Registration Unit

Dental

data available

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

enhanced prescribing data
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

body invaders

Virus

Body Invaders

Fungus

Parasite

Bacteria

clostridium difficile c diff
Clostridium difficile (C Diff)

THE 'NORMAL' GUT BACTERIA

Lactobacilli

Streptococci

Clostridia

Coliform

Bacteriodes

distinct linkage projects dlps
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
slide18

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

nils epd distinct linkage project
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.
prelim results descriptive analysis population distribution prescriptions by sex age
Prelim results: Descriptive Analysis – Population DistributionPrescriptions by Sex & Age
slide22

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

slide23

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

next steps
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
acknowledgements
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
slide26
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