Study to analyze regional differences in antibiotic prescriptions
Description
- Antibiotics are indispensable for the treatment of a large number of bacterial infections and are among the most frequently prescribed drugs in Germany. The vast majority of prescriptions occur in the outpatient sector. The increase and spread of resistant pathogens compromise the effectiveness of antibiotics and thus the medical care of the population. In 2008, the German government launched various measures, including the German Antibiotics Resistance Strategy “DART 2020” developed by the Federal Ministries of Health (Bundesministerium für Gesundheit; BMG), Food and Agriculture as well as Education and Research. DART 2020 was adopted by the Federal Cabinet in May 2015. The problem of resistance was also the subject of the “pharmaceutical dialogue”, in which representatives of pharmaceutical manufacturers, the scientific community, and the trade union “IG BCE” collaborated in the cross-departmental development of agreements to strengthen Germany as a research and manufacturing hub. Regarding antibiotics, the dialog partners agreed, among other things, to strengthen health services research through a study commissioned by the BMG to investigate the background and potential reasons of regional differences in antibiotic prescriptions. In addition, possible changes over time were to be investigated by comparing the results with already published results of other studies conducted based on data up to and including 2014.
The aim of the "Study to Analyze Regional Differences in Antibiotic Prescription" (SARA) was, in the first step, to describe regional differences and differences between age groups in antibiotic prescriptions in Germany based on data from 2015 onwards, to descriptively analyze the time trends of antibiotic prescriptions, and to compare the results with previously published findings for the period 2008–2014. For this purpose, data from the German Pharmacoepidemiological Research Database (GePaRD) were used. In a second step, the potential reasons for the identified differences in antibiotic prescribing were evaluated. This was done in two sub-studies. Based on GePaRD data, potential explanatory factors were identified using multivariable regressions (sub-study 1). In addition, a qualitative study was conducted to assess and classify subjective factors influencing individual prescribing behavior (sub-study 2).
The results and findings from the SARA project have been important in helping to understand the regional causes and differences in antibiotic prescribing practices at the level of 401 districts in Germany over a period from 2008 to 2018. To this end, possible measures and solutions were developed to counteract regulatory action in regions with excessive antibiotic prescribing behavior. According to the BMG, the findings of the SARA project could be taken up as part of the design of the DART 2030 National Action Plans in order to be able to make the use of antibiotics in Germany more rationale.
The final report was submitted to the BMG in September 2022. Initial descriptive results of the project have been published; further publications are currently being prepared.
Funding period
- Begin: April 2019
End: July 2022
Sponsor
- Federal Ministry of Health
Contact
Selected project-related publications
- Scholle O, Asendorf M, Buck C, Grill S, Jones C, Kollhorst B, Riedel O, Schüz B, Haug U. Regional variations in outpatient antibiotic prescribing in Germany: A small area analysis based on claims data. Antibiotics. 2022;11(7):836.
https://doi.org/10.3390/antibiotics11070836 - Scholle O. Regionale Unterschiede bei ambulanten Antibiotikaverordnungen auf Kreis-Ebene: Einblicke in das SARA-Projekt. Runder Tisch des Multiresistente-Erreger-Netzwerks (MRE) im Land Bremen, 16. Februar 2023, Bremen.
- Buck C, Scholle O, Kollhorst B, Haug U. Area-level analysis of regional socio-economic factors on outpatient antibiotic prescribing including claims data from 16 million persons in Germany. 18. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi), 26.-28. September 2023, Würzburg.
- Schüz B, Jones C, Scholle O, Haug U. Regional variations in antibiotic prescribing in Germany: Understanding differences through an adapted theoretical domains framework. 37th Annual Conference of the European Health Psychology Society (EHPS), 4-8 September 2023, Bremen.
- Scholle O, Asendorf M, Buck C, Grill S, Riedel O, Haug U. Antibiotic prescribing in children aged 0-6 years in Germany: Assessing regional variations and potential explanations based on claims data. 37th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE), 23-25 August 2021, online presentation. (Abstract published in: Pharmacoepidemiology and Drug Safety. 2021;30(Suppl.1):94)
- Scholle O, Asendorf M, Buck C, Grill S, Riedel O, Haug U. Antibiotic prescribing in children aged 0-6 years in Germany: Assessing regional variations and potential explanations based on claims data. 16. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi), 20.-22. September 2021, Online-Vortrag.
- Scholle O, Grill S, Haug U. Early life exposure to antibiotics: A comparison of birth cohorts based on German claims data. 15. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi), 29. September 2020, Online-Vortrag.
- Scholle O, Buck C, Kollhorst B, Haug U. Explaining regional variations in outpatient antibiotic prescribing: A small area analysis including over 16 million persons in Germany. 39th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE), 23-27 August 2023, Halifax, Canada. (Abstract published in: Pharmacoepidemiology and Drug Safety. 2023;32(Suppl. 1):602-603)
- Scholle O, Grill S, Haug U. Changes in early life exposure to antibiotics: A comparison of birth cohorts based on German claims data. Kinder- und Jugendmedizin aktuell, 17.-19. September 2020, Online-Poster.