Impact evaluation of guidelines on antibiotic utilisation & appropriateness in Malaysian public primary care: an interrupted time series analysis.
| Autor: | Lim AH; Institute for Clinical Research, National Institutes of Health, Ministry of Health, Malaysia., Ab Rahman N; Institute for Clinical Research, National Institutes of Health, Ministry of Health, Malaysia., Ong SM; Institute for Clinical Research, National Institutes of Health, Ministry of Health, Malaysia., Mohamad Azman SR; Primary Health Sector, Family Health Development Division, Ministry of Health, Malaysia., Mohd Rathi FZ; Primary Health Sector, Family Health Development Division, Ministry of Health, Malaysia., Ismail M; Primary Health Sector, Family Health Development Division, Ministry of Health, Malaysia., Tok PSK; Institute for Clinical Research, National Institutes of Health, Ministry of Health, Malaysia., Kiau Ho B; Bandar Botanik Health Clinic, Klang, Malaysia., Sivasampu S; Institute for Clinical Research, National Institutes of Health, Ministry of Health, Malaysia. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of pharmaceutical policy and practice [J Pharm Policy Pract] 2024 Jun 05; Vol. 17 (1), pp. 2355666. Date of Electronic Publication: 2024 Jun 05 (Print Publication: 2024). |
| DOI: | 10.1080/20523211.2024.2355666 |
| Abstrakt: | Background: The National Antimicrobial Guidelines (NAG) 2014 and NAG2019 in Malaysia targeted rational and judicious use of antimicrobials. In this study, we assessed the change in antibiotic utilisation and appropriateness due to the guidelines that were implemented from 2011 to 2019. Methods: Interrupted time series analyses on rates of antibiotic appropriateness and utilisation were performed using prescription data from public primary care clinics in Malaysia between January 2011 and December 2019. Rates of antibiotic utilisation, reported as Defined Daily Dose (DDD) per 1000 patients per day, were stratified by antibiotic classes. Results: Of the 16,081,492 prescriptions recorded during the study period, 4.98% ( n = 800,899) contained antibiotics. NAG2014 resulted in a significant increase in antibiotic utilisation trend by 0.029 ( p < 0.0001) while NAG2019 had a substantial impact on antibiotic utilisation, decreasing DDD by 1778 and increasing appropriateness by 54.6% ( p < 0.0001). Variation in the number of antibiotic molecules being prescribed also decreased after NAG2019. Conclusion: Our findings indicate that the introduction of NAG2019 led to a substantial improvement in antibiotic appropriateness. At the same time, antibiotic utilisation decreased. Further research is needed to ascertain and ensure the sustainability of these changes and to establish targeted improvement strategies focusing on reducing inappropriate and unnecessary prescribing. Competing Interests: No potential conflict of interest was reported by the author(s). (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.) |
| Databáze: | MEDLINE |
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