add your organisations logo here Optimising Antibiotic Therapy

[add your organisations logo here] Optimising Antibiotic Therapy: Developing a Smartphone App to support prescribing Saarah Niazi-Ali Antibiotic Specialist Pharmacist NHS Tameside and Glossop & Tameside Hospital NHS Foundation Trust Zishan Mohammad Founder and CEO ZIMO i. TS A celebration of those ‘light bulb moments’ that are transforming patient experience and care across the North West

Overview The use of a smartphone app (android and apple) to support antibiotic prescribing in primary care

Introduction • 1. 6 WTE Pharmacists working across interface of Primary and Secondary care • Work with Hospital Consultants, Junior doctors, Nurses, GPs, Midwives etc • Close ties with Microbiology Consultant and GPs in T&G • MDT approach to using antibiotics more appropriately • Big drive to reduce C Diff numbers

Local initiatives • • • Patient information leaflet Individual Practice leaflets GP newsletter Extensive update of Antibiotic Guidelines Posters Scriptswitch message

Patient Information Leaflet

Individual GP Practice leaflets Awburn House Antibiotic Leaflet Important Information for Patients 2012 Here at Awburn House we have been reviewing our prescribing protocols, in particular around the prescribing of antibiotics. Nationally and locally the prescribing of antibiotics has been an increasing worry due to the problems they can cause. As GPs we are under increasing pressure to only prescribe when appropriate and necessary and we would like your help to achieve this. Antibiotics DO NOT work against viruses. Symptoms of a high temperature, headache, sore throat and the common cold are rarely helped by antibiotics. In fact, antibiotics kill the "good" bacteria that occur naturally in your body which can lead to diarrhoea, vomiting and thrush. Taking antibiotics when they are not needed can increase your risk of contracting Clostridium Difficile (C Diff). This is a serious infection of the bowel that can cause stomach cramps, bloating, diarrhoea and death, particularly in the elderly. It occurs when your "good" protective bacteria are killed off by antibiotics. Taking antibiotics frequently can lead to resistance from bacteria - so if you need them desperately in the future antibiotics may not work. Symptoms caused by a viral infection can be helped by paracetamol, fluids and similar products - the pharmacist can advise you regarding this. With these issues in mind, you may notice some changes at Awburn House • We need to see and examine you before prescribing antibiotics. • We will only prescribe antibiotics over the phone under the most exceptional circumstances. • Antibiotic courses may be shorter. You may be given a "delayed" prescription to be taken

GP newsletter

Updated antibiotic guidelines Management of Infections in Primary Care Second Edition Updated: January 2012 Review date: January 2014 These guidelines are regularly updated; please check the PCT intranet for the latest version.

Posters

Scriptswitch © message Risk/Benefit assessment information ‘Antibiotics are important in combating infections but equally it is important they are used correctly particularly as their incorrect use exposes the elderly to the risk of contracting C. diff. The link to the PCT’s revised Antibiotic Guidelines is Management of Infection If this antibiotic is for a 65 year old + patient please consider the following risk factors for C. diff , the more that apply the greater that this patient is at risk of C. diff. : This patient has a previous history of C. diff associated diarrhoea This patient has recently had other courses of antibiotics. This is a prolonged duration course of antibiotics This patient is already taking another antibiotic This patient is receiving a PPI This patient has significant co-morbidities This patient has a naso gastric tube in situ This patient has had a recent invasive procedure including surgical operations and non-surgical GI endoscopic procedures This patient has had a recent prolonged stay in hospital This patient is receiving immunosuppressive therapy This patient is resident in care home This patient has a haematological malignancy

How the project came about • Guidelines updated end of 2011 • GP’s requesting mobile version of guidelines • Imperial and Southampton have app available for their secondary care guidelines • Felt that it would fulfil what GP’s wanted • Business Plan drawn up • Found IT developer • Secured funding • Completed app in June 2012

The Big Question How did you secure funding? ?

Benefits and Uses • • • Increased compliance to guidelines Guidelines are more easily accessible Significant reduction in CDI numbers Its mobile, so can be used anywhere Healthcare professionals are accustomed to using apps • Offline - so internet connection is not necessary

Problems / Barriers • Funding • Downloading issues • No expertise in our IT department • Bringing the GPs up to date with technology

Methodology Requirement Architecture Development Test Deployment • Antibiotic guideline • Field survey • Structure • App flow • i. OS • Android • App. Store • Google Play

App Presentation Designs Feature • • Fast User Friendly Offline No 3 G/Internet required History Search Feedback

Installation Guide i. Phone Android • Download from Appstore via itunes: https: //itunes. apple. com/fr/a pp/nhs-tameside-andglossop/id 562962600? mt=8 • Download from Google Play: https: //play. google. com/stor e/apps/details? id=tameside. glossp&feature=nav_result# ? t=W 251 b. Gws. MSwy. LDNd

Screen shots Home page History page

Screen shots Introduction Information

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S. niazi-ali@nhs. net

Q&A