The government has pledged to support nurse prescribers and other clinicians with tools to reduce unnecessary antimicrobial prescriptions as part of its five-year plan to tackle antimicrobial resistance (AMR).
Such tools could make use of digital technologies including artificial intelligence (AI), but this would depend on ‘fully integrated digital systems’ with the right data governance permissions, the government said.
The new national plan for combatting AMR, published on Wednesday, laid out 30 commitments for the next five years, including several relating to GP practices, care homes and other healthcare settings.
The government stated that ‘reducing unnecessary antimicrobial prescriptions is a core undertaking’ of its plan, with the NHS providing prescribers with tools to aid ‘decision support’ and ‘risk stratification’.
It pointed to the ‘changing’ nature of antimicrobial prescribing, including an increased used of patient group directions (PGDs) and online prescribing, and said the NHS would aim to measure the quality of prescribing and better understand how antimicrobials are prescribed and to who.
By 2029, the government aims to reduce total antibiotic use in human populations by 5% from the 2019 baseline.
As part of its goal to strengthen antimicrobial stewardship, the NHS will support nurse prescribers and other clinicians with new tools which will require the adoption of ‘digital technologies’ such as AI.
‘We will reduce avoidable human exposure to antimicrobials by supporting health and social care teams with decision support, risk stratification tools and judicious use of diagnostic tests, underpinned by improved diagnosis coding, to inform shared decision-making and target antimicrobials to patients most likely to benefit,’ the government stated in one of its key commitments.
This signals an ‘evolution’ of antimicrobial stewardship and the ‘adoption’ of new methods, including a ‘fresh approach’ based on ‘genuine shared decision-making’ with patients, it added.
The government pointed to an increase in ‘non-medical prescribers’, especially within pharmacy given the launch of the Pharmacy First scheme which began at the end of January in England and allows community pharmacies to prescribe antibiotics.
‘Providing tools to support antimicrobial treatment targeted only to patients who need them is critically important for independent non-medical prescribers to optimise diagnostic and therapeutic decision-making, as is continuing to monitor and evaluate the impact of these services on antimicrobial use in the UK,’ the plan added.
‘Frequent unnecessary prescribing’ of antibiotics in care homes
The plan highlighted that ‘frequent prescribing of antibiotics for older patients is widespread’.
And it added that ‘there is evidence to suggest that there is frequent unnecessary prescribing in some settings, such as long-term care facilities’.
‘Social care environments such as care homes have at times been overlooked in the arena of AMR programmes, but they are important places where gains can be made to reduce levels of resistant organisms,’ the government said.
And it committed to collecting and reporting AMR data in the context of health inequalities ‘to help inform interventions for marginalised, disadvantaged or vulnerable populations’.
Professor Sir Stephen Powis, NHS national medical director, welcomed the strategy and said: ‘Effective antibiotics are fundamental to providing the best care and treatment for patients both in the NHS and globally, so it is only right that we move to tackle the major issue of antibiotic resistance.’
Versions of this article were first published by our sister titles Pulse and The Pharmacist
