Why collect data on age and gender? Added value of national antimicrobial consumption data on age and gender?

Hege Salvesen Blix

Senior researcher, Norwegian Institute of Public Health Professor, School of Pharmacy, University of Oslo

WHO Collaborating Centre for

Drug Statistics Methodology

Outline

USING DDDs: Norway is a low-use country

ECDC Report - ESAC-net

Consumption of antibacterials (J01), 2012, expressed as DDD per 1 000 inhabitants and per day)

However, while use of antibiotics increase in Norway,

use decrease in Sweden

Source NOMESCO

Use of Antibiotics (J01, excl. Methenamine) in primary care in Norway, 2013 – age and gender

Who use antibiotics – source NorPD

Misuse!

Use of Antibiotics (J01, excl. Methenamine) in primary care in Sweden, 2013 – age and gender

source:http://www.socialstyrelsen.se

J01 - Gender difference in Norway and Sweden – changes over years source:

http://www.socialstyrelsen.se/statistik/statistikdatabas/lakemedel http://www.reseptregisteret.no/

J01 - Trend over years - women

Use of antibiotics (J01) in small children 0-4 years. Trends

If we should do something – age- and gender targets for intervention?.....

• Women

• Small children 0-5 years

• … and for Norway the 19-years olds

What else should we like to know in addition to age and gender?

• Indication for use

• Therapy patterns according to Guidelines (i.e. within indications)

Norway

Sweden

Where are the problems today? Age – Gender – «indications»

• Children (0-9 years) • 4% of AB-use in DDD • 8,5 % of prescriptions • RTIs (+ choice of AB)

• Youths (10-24 years) • 16 % of AB-use in DDD • 14 % of prescriptions • UTI/sexually transmitted diseases • Acne treatment

• Adults (25-65 years) • 53 % of AB-use in DDD • 51 % of prescriptions

• Elderly (over 65 years) • 27 % of AB-use in DDD • 27 % of prescriptions • UTIs

Figure - Estimate of indication Therapy patterns given as proportions of prescriptions in different age groups

Patterns of use by gender and age groups? Proportions (%) of DDDs, 2013

Is it possible to set targets for antibiotics?

When you set targets, you must be able to measure it.

We have

ATC codes, DDDs, number of users, Rx, age and gender

No indications, but we can estimate use

Gender differences and county differences (2013) – Antibiotics used for urinary tract infections

Target: «No more than 8 % of Rx for urinary tract infections in women 20-79 years should be quinolones»

Women Men

The ultimate challenge is

– how to change

inappropriate patterns?

Questions

"If you can not measure it,

you can not improve it."