Longitudinal regional analyses of an1bio1c consump1on in statutory health care insured pa1ents in Germany since 2008
|
|
- Edward Austin
- 5 years ago
- Views:
Transcription
1 Longitudinal regional analyses of an1bio1c consump1on in statutory health care insured pa1ents in Germany since 2008 Jörg Bätzing- Feigenbaum - Maike Schulz - Mandy Schulz - Jana Gisbert Miralles - Dominik Graf von S1llfried Wennberg Interna1onal Collabora1ve (WIC) Research Mee1ng London - September 2-4, 2015 Zentralinstitut für die Kassenärztliche Versorgung in Deutschland
2 Background Ø Increasing bacterial resistance against an1bio1c drugs is a major Public Health concern worldwide Ø In 2008 the Federal Government implemented a na1onal German An1bio1c Resistance Strategy ( Deutsche An1bio1ka- Resistenzstrategie, DART) Ø DART: latest 5- year- plan Update in 2013 Ø One priority of DART is: monitoring of an1bio1c consump1on in Germany Ø Surveillance of an1bio1c consump1on up to now is focusing on the hospital sector (Robert Koch- Ins1tute, Berlin) SEITE 2 von 24
3 An1bio1c consump1on in Europe (EU, Iceland, Norway) 2012 European Centre for Disease Preven1on and Control (ECDC). Surveillance of an1- microbial consump1on in Europe ECDC. Stockholm 2014 SEITE 3 von 24
4 Trends of cephalosporine prescrip1ons in Europe (EU, Iceland, Norway) European Centre for Disease Preven1on and Control (ECDC). Surveillance of an1- microbial consump1on in Europe ECDC. Stockholm 2014 SEITE 4 von 24
5 Why should we look at ambulatory (outpa1ent) an1bio1c prescrip1on data in Germany? Ø 85% of all an1bio1cs used in the ambulatory health care sector, however, surveillance s1ll focusing on hospital data Ø Above- average use of cephalosporins in Germany Ø Increasing role of cephalosporins in the last decade Ø S1ll important role of fluorchinolones SEITE 5 von 24
6 Main problems due to cephalosporins and fluorchinolones Ø Both, cephalosporins and fluorchinolones are suspected to promote bacterial resistance par1cularly in gram- nega1ve bacteria ( ESBL proper1es ) Ø Fluorchinolones are suspected to result more oden than other an1bacterials in intes1nal superinfec1on with C. difficile responsible for increased risk of severe disease and mortal1ty in elderly pa1ents Ø Use as second- line an1bio1cs SEITE 6 von 24
7 Previous publica1ons on regional varia1ons of an1bio1c prescrip1ons in Germany in Ø (1) Regional varia1on of popula1on- based an1bio1c prescrip1on rates in Germany in 2010 (published ) Ø (2) Regional varia1on of an1bio1c prescrip1on rates in certain infec1ous diseases in Germany in 2009 (published ) Ø (3) Regional varia1on of popula1on- based an1bio1c prescrip1on rates over 1me in Germany (published ) SEITE 7 von 24
8 (1) Popula1on- based an1bio1c prescrip1on rates in Germany in 2010 by regions % of all pa1ents with at least one an1bio1c prescrip1on per year (N = 69.5 million insurees) SEITE 8 von 24
9 (2) An1bio1c prescrip1on rates in certain infec1ous diseases in 2009 by regions (2a) Upper respiratory tract infec1ons: % of pa1ents with an1bio1c prescrip1on (led) Quality indicators (ECDC guidelines) recommand max. 30% and treatment with chinolones max. 5% % of physicians with <5% chinolone prescrip1ons in URT infec1ons (below) N = 17.3 million pa1ents included SEITE 9 von 24
10 (2) An1bio1c prescrip1on rates in certain infec1ous diseases in 2009 by regions (2b) Pharyngi1s & tonsilli1s: % of pa1ents with an1bio1c prescrip1on (led) Quality indicators (ECDC guidelines) recommand max. 20% and treatment with chinolones max. 5% % of physicians with <5% chinolone prescrip1ons in URT infec1ons (below) N = 3.4 million pa1ents included SEITE 10 von 24
11 (3) popula1on- based an1bio1c prescrip1on rates over 1me (3a) Descrip1ve: DDD per insurees, na1on- wide by age groups (3b) Descrip1ve: DDD per insurees, age group 0-14 years by regions N=70.0 (2008); 69.7 (2009); 69.5 (2010); 69.3 (2011); 69.4 million (2012) insurees SEITE 11 von 24
12 (3) popula1on- based an1bio1c prescrip1on rates over 1me (3c) Joinpoint Regression Model: Annual percent change (APC) of DDD per insurees, by age groups and regions N=70.0 (2008); 69.7 (2009); 69.5 (2010); 69.3 (2011); 69.4 million (2012) insurees SEITE 12 von 24
13 (3) popula1on- based an1bio1c prescrip1on rates over 1me (3d) Descrip1ve: Abs. and % of an1bio1c drug groups in DDD per insurees, na1onwide, age group 69 years N=70.0 (2008); 69.7 (2009); 69.5 (2010); 69.3 (2011); 69.4 million (2012) insurees SEITE 13 von 24
14 (3) popula1on- based an1bio1c prescrip1on rates over 1me (3e) Combined regional results: Prescrip1ons (led) and DDD per insurees (right) N=70.0 (2008); 69.7 (2009); 69.5 (2010); 69.3 (2011); 69.4 million (2012) insurees SEITE 14 von 24
15 Current work in progress: Popula1on- based development of the prescrip1on rates over 1me ( ) with focus on cephalosporins and chinolones Ø Na1onwide claims data bases containing 100% of the na1onwide statutorily insured pa1ents (~ 70 million, 86% of the total popula1on) Ø 100% of physician claims (~ 550 million cases p.a.) Ø 100% of filled prescrip1ons (~ 600 million prescrip1ons p.a.) SEITE 15 von 24
16 Results Total of an1bio1c drug prescrip1ons in DDD per insurees between 2008 and 2014, na1onwide by age groups SEITE 16 von 24
17 Results % of an1bio1c drug groups prescribed in 2008 and 2014, na1onwide by age groups SEITE 17 von 24
18 Results Fluorchinolones: Prescrip1ons in DDD per insurees by age groups (15-69 years above; <69 years below) in 2008 and 2014, and by regions (fluorchinolons by group 1-3) SEITE 18 von 24
19 Results Cephalosporins: Prescrip1ons in DDD per insurees by age groups (15-69 years above; <69 years below) in 2008 and 2014, and by regions (cephalosporins by genera1on 1-3) SEITE 19 von 24
20 Results Joinpoint Regression Model: Annual percent change (APC) and p- values of total an1bio1c, cephalosporin and fluorchinolone prescrip1ons in DDD per insurees by age groups and regions between 2008 and 2014 DDD je GKV- Versicherte (Antibiotika insgesamt) DDD je GKV- Versicherte (Cephalosporine) DDD je GKV- Versicherte (Fluorchinolone Alter (Jahre) <15 Jahre J. >69 Jahre gesamt <15 Jahre J. >69 Jahre gesamt J. >69 Jahre gesamt Bundesland APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert APC p- Wert SH - 4,97 <0,001 1,32 0,05-0,29 0,85 0,63 0,23 0,52 0,66 9,34 <0,01 8,86 <0,001 7,39 <0,01-0,25 0,80-1,49 0,08-0,19 0,83 HH - 6,53 <0,001 1,39 0,10 0,39 0,75 0,42 0,52-2,73 0,15 11,98 <0,001 9,43 <0,001 7,93 <0,01-0,25 0,73-1,05 0,12-0,04 0,95 HB - 4,40 0,01 2,64 <0,05 2,06 0,17 1,84 0,12 0,39 0,50 8,65 <0,001 8,22 <0,001 6,45 <0,001 2,64 0,05 1,18 0,24 2,62 0,03 NI - 7,20 <0,001 0,47 0,51-1,41 0,37-0,51 0,45-1,54 0,22 9,34 <0,01 8,00 <0,01 6,93 <0,01-0,15 0,80-2,17 <0,01-0,35 0,52 NRW - 6,52 <0,01 0,40 0,59-0,63 0,54-0,57 0,41-1,02 0,53 10,25 <0,01 8,31 <0,01 7,33 <0,01-0,62 0,39-2,61 <0,01-0,63 0,39 HE - 6,30 <0,01 0,04 0,96-2,27 0,10-0,80 0,31 0,57 0,68 11,73 <0,01 8,04 <0,01 8,89 <0,01 0,12 0,89-2,11 <0,01-0,16 0,84 RLP - 5,93 <0,01 1,24 0,20-0,73 0,53 0,19 0,82-0,16 0,92 12,13 <0,01 9,95 <0,001 9,13 <0,01 0,52 0,67-1,92 <0,05 0,14 0,90 BW - 5,64 <0,01 0,08 0,91-1,89 0,20-0,64 0,41-0,50 0,73 9,22 <0,01 7,54 <0,01 6,63 <0,01-1,66 <0,01-3,14 <0,001-1,70 <0,01 BAY - 6,19 <0,01 0,27 0,73-1,47 0,28-0,52 0,49-0,84 0,47 10,63 <0,01 9,07 <0,001 8,04 <0,01-1,42 0,06-2,76 <0,0001-1,40 0,04 BE - 6,83 <0,001 0,48 0,48-0,34 0,64-0,53 0,41-3,90 0,09 12,56 <0,01 11,39 <0,001 8,36 <0,01-0,42 0,57-2,13 0,02-0,56 0,46 SL - 5,20 <0,01 1,19 0,21 0,14 0,86 0,01 0,99-0,12 0,93 9,20 <0,01 7,72 <0,001 6,10 <0,01 0,54 0,53-1,78 <0,01 0,23 0,76 MV - 8,27 <0,01 1,20 0,27-0,07 0,96-0,25 0,80-5,53 <0,1 12,83 <0,01 12,63 <0,001 8,10 0,01-1,38 0,23-3,12 <0,01-1,51 0,16 BB - 7,99 <0,001-0,86 0,49-2,52 0,11-1,95 0,12-4,16 0,13 10,55 0,01 8,25 0,01 6,84 0,04-2,20 0,07-3,98 <0,01-2,72 0,04 ST - 8,43 <0,001 1,14 0,25-3,69 <0,01-1,27 0,18-5,70 0,08 12,41 <0,01 5,59 0,01 6,37 0,02-0,23 0,79-4,61 <0,0001-1,39 0,07 TH - 9,79 <0,01 5,56 0,03-13,34 <0,01-1,32 0,22-4,00 0,18 18,39 <0,01-2,54 0,35 8,11 0,01 4,12 0,10-10,34 <0,001-2,14 0,05 SN - 8,84 <0,01 0,15 0,89-1,57 0,20-1,35 0,22-8,45 0,02 11,23 <0,01 7,49 <0,01 5,59 0,04-1,50 0,09-3,28 <0,001-1,67 0,06 Bund - 6,68 <0,01 0,60 0,42-1,60 0,18-0,52 0,46-1,52 0,31 10,74 <0,01 8,05 <0,01 7,57 <0,01-0,60 0,38-2,89 <0,001-0,95 0,16 SEITE 20 von 24
21 Limita1ons Ø Drug prescrip1on data up to now only available on regional level ( federal state ), not on District level Ø % statutory care insurees underlies a broad range of varia1on on regional and District levels between ~ 70 and ~ 97% of the total popula1on Ø An1bio1c prescrip1ons from den1sts are not included (es1mated ~ 10% of all an1bio1cs prescribed na1onwide) Ø Prescrip1on data only include those physicians prescrip1ons which have been claimed by the pa1ents; furthermore, we do not know, if pa1ents actually took their medica1on SEITE 21 von 24
22 Conclusions Ø Claims data may contribute with solid descrip1ve and analy1cal results to the surveillance of an1bio1c prescrip1ons and consump1on in ambulatory health care in Germany Ø The data can reasonably complement na1onal surveillance data Ø Results show regional varia1on and varia1on by age groups poin1ng to regions of best prac1ce Ø Declining trends of general an1bio1c prescrip1ons in children and young adults are significant in all German regions SEITE 22 von 24
23 Conclusions Ø Significant trends call for a na1onwide interven1on to reduce cephalosprin prescrip1ons in the future Ø Declining Fluorchinolone prescrip1ons in the elderly though mostly not significant reveal further need for ac1on Ø Best way of communica1on of the results to the prescribing physicians and how to get them on board is s1ll an unsolved challenge for SEITE 23 von 24
24 Thank you very much for your aren1on Central Research Institute of Ambulatory Health Care in Germany (Zi) Herbert-Lewin-Platz Berlin Germany Tel Fax zi@zi.de SEITE 24 von 24
The Wennberg International Collaborative, London, 2-4 September 2015
The Wennberg International Collaborative, London, 2-4 September 2015 Diagnosis and Treatment of Dementia Variation in ambulatory care for patients in Germany with special reference to non-institutionalized
More informationThe problem with an0bio0cs. Oct CCST Council Mee0ng Mar0n J. Blaser, MD New York University
The problem with an0bio0cs Oct 27 2015 CCST Council Mee0ng Mar0n J. Blaser, MD New York University Br J Exp Pathol 1929;79:780. J Clin Invest 1945;24:589. Top 8 prescrip0ons in US children, 2010 Prescrip0on
More informationSubstan(al geographic varia(on in French mental health admission rates suggest cultural differences in admi8ng prac(ces
Substan(al geographic varia(on in French mental health admission rates suggest cultural differences in admi8ng prac(ces Wennberg Interna(onal Collabora(ve London September 2, 2015 William B Weeks, MD,
More informationListeria monocytogenes. Tom Duszynski, MPH, REHS Director of Surveillance and Inves>ga>on
Listeria monocytogenes Tom Duszynski, MPH, REHS Director of Surveillance and Inves>ga>on References Scallan, E., Hoekstra R.M., Angulo F.J., Tauxe R.V., Widdowson M.A., Roy S.L., et al. Foodborne illness
More informationThe German AMR Strategy, One Health - Global Health
The German AMR Strategy, One Health - Global Health Lothar H. Wieler Robert Koch Ins@tute PAC 11 Side- Event From strategies to ac7on Adressing the challenges of AMR in the Northern Dimension Area Berlin,
More informationGlobal health; understanding, approach and major issues
Global health; understanding, approach and major issues Gabriel Gulis Unit of health promotion research Institute of public health, Faculty of medical sciences University of Southern Denmark Esbjerg, Denmark
More informationMental Health, Substance Abuse & Primary Care: Bridging Gaps in Access
1 Mental Health, Substance Abuse & Primary Care: Bridging Gaps in Access Christopher Carroll, Director, Health Care Financing and Systems Integration Substance Abuse and Mental Health Services Administration
More informationCancer Survival in First Nations and Métis: Follow-up of the 1991 Census Mortality Cohort!
Cancer Survival in First Nations and Métis: Follow-up of the 1991 Census Mortality Cohort! Diana Withrow! June 24 th, 2014! NAACCR Annual Conference! Ottawa, ON! Outline & Goals! Background! Aims! Methods!
More informationEngage and Empower Pa.ents with Interac.ve Technology. Northeast NAHAM Regional Conference Pa.ent Access: GeBng It Right Upfront October 22-23, 2012
Engage and Empower Pa.ents with Interac.ve Technology Northeast NAHAM Regional Conference Pa.ent Access: GeBng It Right Upfront October 22-23, 2012 NAHAM - Pa.ent Access Services 2 Pa%ent Access Services
More informationImmunize. Prevent what s preventable Stakeholder Mee1ng.
Immunize. Prevent what s preventable. 2016 Stakeholder Mee1ng www.immunizeusa.org Housekeeping Facebook.com/immunizeusa @immunize_usa #BeHerdTX Evalua?ons White- TIP evalua?on Blue- CE evalua?on Trivia
More informationAntibiotic Use in the Outpatient Setting. Ryan Bariola, MD FIDSA Visi4ng Clinical Associate Professor of Medicine
Antibiotic Use in the Outpatient Setting Ryan Bariola, MD FIDSA Visi4ng Clinical Associate Professor of Medicine Nothing to disclose Disclosures Case 43 year old pa4ent schedules appointment for cough
More informationSECTION 1: ABOUT HEPATITIS
SECTION 1: ABOUT HEPATITIS Hepa33s Means Swollen Liver Many things can cause your liver to become swollen, including drinking a lot of alcohol; taking certain medica3ons or herbs; inhaling toxic fumes;
More informationOncology Care Model Overview
Oncology Care Model Overview Centers for Medicare & Medicaid Services Innova3on Center (CMMI) September 2017 Innova3on at CMS Center for Medicare & Medicaid Innova3on (Innova3on Center) Established by
More informationThe Availability of Homeopathic Medicinal Products (HMPs) in Europe with reference to the Matrix Report
The Availability of Homeopathic Medicinal Products (HMPs) in Europe with reference to the Matrix Report A presenta@on to the European Parliament CAM Interest Group 1 July 2015 By Stephen Gordon General
More informationWHO posi)on paper on influenza vaccines*
WHO posi)on paper on influenza vaccines* Geneva, Switzerland Published in the Weekly Epidemiological Record on 23 November 2012 * This posi(on paper is concerned mainly with vaccines and vaccina(on against
More informationTuberculosis and Non-Communicable Diseases
Tuberculosis and Non-Communicable Diseases Hannah Monica Dias Policy, Strategy and Innova8ons Second Mee8ng of the WHO Global Coordina8on Mechanism (GCM/NCD) Working Group on the inclusion Of NCDs in other
More informationMeaningful Use of Meaningful Use
Meaningful Use of Meaningful Use Kevin Larsen MD Medical Director, Meaningful Use Office of the Na;onal Coordinator of Health IT March 7 2013 Our Na;onal Quality Strategy Aims Be#er Health for the Popula0on
More informationBiobanking in Finland
Biobanking in Finland Anu Jalanko 28.11.2016 1 Major Health reform in Finland The government has published dra4 bills on health, social services and regional government reform One of the largest ever administra9ve
More informationDengue Situa0on Update Number 521. Update on the Dengue situa0on in the Western Pacific Region
Update on the Dengue situa0on in the Western Pacific Region Northern Hemisphere Dengue Situa0on Update Number 521 18 July 2017 Cambodia As of 14 July 2017, a total of 1,056 suspected dengue fever cases
More informationTuberculosis surveillance in Germany. Data of the tuberculosis report 2013
1 Tuberculosis surveillance in Germany Data of the tuberculosis report 2013 Robert Koch Institute (RKI) Respiratory Infections Unit Outline 2 Tuberculosis notification system in Germany Epidemiological
More informationRespiratory Tract Infec1ons Long Term Care. Dr Karsten Hammond Infec1ous Diseases 28 March 2015
Respiratory Tract Infec1ons Long Term Care Dr Karsten Hammond Infec1ous Diseases 28 March 2015 Disclosures I have no financial rela1onships to disclose 82 yo Female In LTC for two years, total care from
More informationHow does Active Mobility. Dr. Ute Winkler, Federal Ministry of Health, Germany
How does Active Mobility help to reach the SDGs? Dr. Ute Winkler, Federal Ministry of Health, Germany SDGs and Physical Activity Sustainable Development Goal 3: Ensure healthy lives and promote well-being
More informationSt. Louis Regional Asthma Coalition
Session 25 Update-Emergent Care of Students with Asthma for 20 th Annual Missouri Coordinated School Health Coalition Conference November 30, 2012 William L. Kincaid, MD, MPH 314-780-7635 WLKINCAID@swbell.net
More informationDiabetes Self- management Educa4on and Support (DSME/S)
Improving Patient Care Through Diabetes Self- management Education Davida F. Kruger, MSN, APN-BC, BC-ADM Certified Nurse Practitioner Henry Ford Health System Division of Endocrinology, Diabetes, Bone
More informationPatients at High Risk Experience, Guidelines, and Best Practices. Mozambique. José Tique, MD MPH MoH July 17-19, 2017 Harare, Zimbabwe
Patients at High Risk Experience, Guidelines, and Best Practices Mozambique José Tique, MD MPH MoH July 17-19, 2017 Harare, Zimbabwe Content Scope of the Problem Treatment Guidelines Best Prac9ces Differen9a9ng
More informationShould Me*ormin be contraindicated in pa4ents with CKD? TAYLOR MCBRIDE UNIVERSITY OF TEXAS/HEB PGY-1 COMMUNITY PHARMACY RESIDENT
Should Me*ormin be contraindicated in pa4ents with CKD? TAYLOR MCBRIDE UNIVERSITY OF TEXAS/HEB 2018-2019 PGY-1 COMMUNITY PHARMACY RESIDENT 1 Objec4ves Understand the changes to Me*ormin labeled use in
More informationE. Scafato C. Gandin, L. Galluzzo, S. Ghirini, S. Martire, R. Scipione Istituto Superiore di Sanità, Italy
Guidelines to support early identification and brief interventions for alcohol use disorders in Europe: overview of RARHA survey results and of other EU projects E. Scafato C. Gandin, L. Galluzzo, S. Ghirini,
More informationWomen s Oral Health An overview. Dr Paula Vassallo President Council of European Chief Dental Officers
Women s Oral Health An overview Dr Paula Vassallo President Council of European Chief Dental Officers Defini@on Women s Health has been defined as diseases or condi@ons that are unique to, more prevalent
More informationBeyond Housing 2016: Raising the Roof and Homelessness in Canada
Beyond Housing 2016: Raising the Roof and Homelessness in Canada Agenda A Snapshot of Homelessness in Canada About Us: Raising the Roof Public Educa
More informationSurviving Sepsis and Stewardship
Surviving Sepsis and Stewardship Start Smart Then Focus Are these hopelessly compe5ng objec5ves? Dr David R Jenkins, Consultant Medical Microbiologist and Infec>on Control Doctor, University Hospitals
More informationEconomic outcomes: Method for implementa5on
Economic outcomes: Method for implementa5on Philippe Beutels Centre for Health Economics Research & Modelling Infec
More informationSIMPATH Y. S*mula*ng Innova*on Management of Polypharmacy and Adherence in the Elderly Simpathy
S*mula*ng Innova*on Management of Sunfrail Transla1onal workshop Understanding and caring for frailty and mul1morbidity Bologna, March 22nd 2016 S*mula*ng Innova*on Management of Polypharmacy and Adherence
More informationObjec&ves. 1. Review the importance of QI in thyroid & thyroid cancer surgery
Objec&ves 1. Review the importance of QI in thyroid & thyroid cancer surgery 2. Be aware of contemporary complica&on rates for thyroid/thyroid cancer opera
More informationNutrigenetics and Nutrigenomics in Clinical Research and Practice
Nutrigenetics and Nutrigenomics in Clinical Research and Practice Mar$n Kohlmeier, MD, PhD University of North Carolina at Chapel Hill Department of Nutri7on and UNC Nutri7on Research Ins7tute mkohlmeier@unc.edu
More informationby author ESCMID Online Lecture Library Malaria Epidemiology, diagnosis and risk of resurgence Eskild Petersen Professor, MD, DMSc
Malaria Epidemiology, diagnosis and risk of resurgence Eskild Petersen Professor, MD, DMSc Department of Infectious Diseases Aarhus University Hospital, Skejby Specialist of Infectious Diseases and Tropical
More informationIMPROVING GLOBAL ESTIMATES: PROCESS AND MILESTONES IATT Webinar June 7 th 2016
Where did we start? Where did we get to? Where do we want to go? IMPROVING GLOBAL ESTIMATES: PROCESS AND MILESTONES IATT Webinar June 7 th 2016 Mar6na Penazzato Paediatric advisor HIV Department WHO, Geneva-
More informationCollabora'on to Prevent and Control Cervical Cancer in La'n America and the Caribbean
Collabora'on to Prevent and Control Cervical Cancer in La'n America and the Caribbean Partnership between PAHO- USG- ACS- RINC Mona Saraiya, MD, MPH CDC Associate Director for Interna@onal Cancer Control
More informationGermany (DGMM) Total: 5064
Germany (DGMM) 2017 Umbrella organiza.on of 3 individual groups, exclusively physicians/surgeons on capacity level (DAS), to gather forces on na.onal and interna.onal level MWE (Physicians for Manual Treatment
More informationWelcome! Pragmatic Clinical Studies. David Hickam, MD, MPH Program Director Clinical Effectiveness Research. David Hickam, MD, MPH
Pragmatic Clinical Studies David Hickam, MD, MPH Program Director Clinical Effec2veness Research June 23, 2015 Welcome! David Hickam, MD, MPH Program Director Clinical Effectiveness Research 2 In this
More informationPublic Health / Public Works Introduc6on, reitera6on + Lessons 1-2. Pioneer Winter IDH 3034, IDH 4007
Public Health / Public Works Introduc6on, reitera6on + Lessons 1-2 Pioneer Winter IDH 3034, IDH 4007 What s the purpose of this class? Learning Objec6ves Understand the principles of public health, epidemiology,
More information10/26/15. Perspec'ves on maternal opioid use and abuse. Dr. Rita J. Nutt. Our Expectation. Harsh Realities
10/26/15 Perspec'ves on maternal opioid use and abuse Dr. Rita J. Nutt Our Expectation Harsh Realities 1 Opioid Abuse and Dependence Statistics, 2013 4.5 million people in the US current non- medical users
More informationCross border preparedness and response: Key health issues and challenges
Cross border preparedness and response: Key health issues and challenges Prince Mahidol Award Conference Bangkok, Thailand February 1, 2013 Prof. Mahmudur Rahman, PhD Director Ins/tute of Epidemiology,
More informationContributions to health outcomes research Rheumatoid Arthritis. Study objective: Database: Author: Version: Date:
Contributions to health outcomes research Rheumatoid Arthritis Study objective: Database: Author: Version: Date: Analysis of patient journeys and their resource consumptions in Germany Insurants presenting
More informationHemophilia Federa.on of America Inhibitor Track 3/26/2015. Developed by Debbie Porter, Reduce Inhibitor Development (RID) 1
MISSION The Hemophilia Federation of America (HFA) is a national nonprofit organization that assists and advocates for the bleeding disorders community. RID Reduce Inhibitor Development Debbie Porter March
More informationEduca'onal Interven'on to Prevent Alcohol Abuse Among Students. 10 years of declining nega1ve consequences
Educa'onal Interven'on to Prevent Alcohol Abuse Among Students 10 years of declining nega1ve consequences James C. Turner, MD Execu've Director Department of Student Health Na'onal Social Norms Ins'tute
More informationPost doctor Rune Jonassen. Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway
Post doctor Rune Jonassen Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway MDD epidemiology Depression is the leading cause of disability worldwide. An es=mated 350 million
More informationHRSA Ini)a)ves to Address Hepa))s C and Health Dispari)es September 7, 2017
HRSA Ini)a)ves to Address Hepa))s C and Health Dispari)es September 7, 2017 Letha Healey, MD Pamela Belton Sara Woody Division of Domes)c HIV Programs Office of Training and Capacity Development (OTCD)
More informationConference Synthesis: Summary & Recommenda6ons Saturday 3 February Saturday, February 3, 18
Conference Synthesis: Summary & Recommenda6ons Saturday 3 February 2018 Conference programme structure Pre-conference: 29 31 January 2018 40 side mee;ngs 6 field trips Main conference 1 3 February 2018
More informationDiagnos(c U(lity of CRP in the ED. Joanna Middleton
Diagnos(c U(lity of CRP in the ED Joanna Middleton Objec(ves Review the u(lity of a CRP in diagnosing various ED condi(ons Discovery 1930 TilleF and Francis Substance in serum that reacted with C- polysaccharide
More informationFunctional Design Targets! Hospital Infection Control!
2017 Healthcare Surfaces Summit Functional Design Targets! Hospital Infection Control! Max Munn, CEO and Founder Munnworks, LLC Problem: Sinks in hospital bathrooms are major source of microbes that cause
More informationMedication Adherence Campaign Target Market Tracking Survey Results National Consumers League October 9, 2015
Medication Adherence Campaign Target Market Tracking Survey Results National Consumers League October 9, 2015 Objectives An ini%al target market survey was launched in May 2011 to serve as a benchmark
More informationDevelopment and Applica0on of Real- Time Clinical Predic0ve Models
Development and Applica0on of Real- Time Clinical Predic0ve Models Ruben Amarasingham, MD, MBA Associate Professor, UT Southwestern Medical Center AHRQ- funded R24 UT Southwestern Center for Pa?ent- Centered
More informationStudy Designs in HIV Research
Study Designs in HIV Research Colette Smith (based on slides from Fiona Lampe) UK CAB meeting Thursday 17th August 2017 Main types of research studies Cross-sectional Observational Ecological Cohort Case-control
More informationUpper Extremity Fractures and Secondary Fall Prevention: Opportunities to Improve Management and Outcomes Across Disciplines.
Upper Extremity Fractures and Secondary Fall Prevention: Opportunities to Improve Management and Outcomes Across Disciplines Chris,ne McDonough, PhD, PT, CEEAA Health Outcomes Unit Department of Health
More informationSuicide in Missouri: Where We Stand
Suicide in Missouri: Where We Stand Liz Sale Missouri Ins6tute of Mental Health University of Missouri-St. Louis June 2016 Outline Prevalence of suicide World, U.S., Missouri comparisons Trends over 6me
More informationFamily Nutri,on: Mee#ng everyone s needs
Family Nutri,on: Mee#ng everyone s needs Candy Richardson, RDN, LDN, CNSC Duke Children s Neuromuscular Program Our Topics for This Session Unique needs : individualized nutri,on The roles of the individual
More informationField research to iden/fy infec/ous agents in animals and the environment to a6empt to predict emergence
Field research to iden/fy infec/ous agents in animals and the environment to a6empt to predict emergence John S Mackenzie Plenary session 3: Policies and Strategies to Meet the Challenge of Emerging Disease
More informationTRAVEL MEDICINE INFORMATION SERVICE MODEL
TRAVEL MEDICINE INFORMATION SERVICE MODEL - - ast majority of migrants have spent more than a few weeks on the migration route before arrival in Croatia, most diseases reported in dispatch have
More informationF. Bochicchio The approach of the INRAP for preven8on and mi8ga8on and the new Direc8ve on BSS. Radon Protec8on Conf. Dresden, 2 3 Dec.
Radon protec8on conference New challenges for the European construc8on and ven8la8on branches of Europe Dresden (Sachsen, Germany) December 2 nd 3 rd 2013 The approach of the Italian Na1onal Radon Ac1on
More informationCarbapenem-resistant infections on the rise in Europe Presentation by Dr Marc Sprenger, ECDC director, Brussels Press Club, 15 November 2013
ECDC DIRECTOR S PRESENTATION Carbapenem-resistant infections on the rise in Europe Presentation by Dr Marc Sprenger, ECDC director, Brussels Press Club, 15 November 2013 For the launch of the 6th European
More informationBee propolis in the treatment of Helicobacter pylori: in the right way to clinical applica5on
Bee propolis in the treatment of Helicobacter pylori: in the right way to clinical applica5on Marco Biagi UNIVERSITÀ DEGLI STUDI DI SIENA SOCIETA ITALIANA DI FITOTERAPIA Helicobacter pylori Helicobacter
More informationWHO posi)on paper on pneumococcal vaccines. Geneva, Switzerland Published in the Weekly Epidemiological Record on 6 Apr 2012
WHO posi)on paper on pneumococcal vaccines Geneva, Switzerland Published in the Weekly Epidemiological Record on 6 Apr 2012 WHO posi)on paper on pneumococcal vaccines, April 2012 The current posi)on paper
More informationLearning Objec1ves. Study Design Considera1ons in Clinical Pharmacy
9/28/15 Study Design Considera1ons in Clinical Pharmacy Ludmila Bakhireva, MD, PhD, MPH Pree Sarangarm, PharmD, BCPS Learning Objec1ves Describe the features, advantages and disadvantages of the observa1onal
More informationNa#onal Trends in Addic#on Medicine. Ohio Chapter of the American Society of Addic4on Medicine 2017 Annual Mee4ng Wednesday, August 2, 2017
Na#onal Trends in Addic#on Medicine Ohio Chapter of the American Society of Addic4on Medicine 2017 Annual Mee4ng Wednesday, August 2, 2017 Ohio Chapter of the American Society of Addic4on Medicine 2017
More informationLearning Objec1ves. Study Design Strategies. Cohort Studies 9/28/15
9/28/15 Learning Objec1ves Describe the features, advantages and disadvantages of the observa1onal study designs Explain why the overall study design is important when evalua1ng studies & applying their
More informationWhat are the key challenges in implementing Stewardship the AMS team view
What are the key challenges in implementing Stewardship the AMS team view Philip Howard Consultant Pharmacist Twitter: AntibioticLeeds philip.howard2@nhs.net www.england.nhs.uk/ourwork/patientsafety/amr
More informationUniversality and Palliative Care
Universality and Palliative Care Hacia la Universalidad Efectiva del Sistema de Salud: Acceso a Cuidados Paliativos y Control del dolor Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
More information3/31/2015. Designing Clinical Research Studies: So You Want to Be an
Designing Clinical Research Studies: So You Want to Be an Inves@gator Andrea Bonny, MD Ellen Lançon Connor, MD On behalf Of The NASPAG Research CommiPee Objec@ves Learn to design a clinical research project
More information2015 Na(onal Medicaid and CHIP Oral Health Symposium. Integra(ng Oral and General Healthcare. Bruce Donoff, DMD, MD. Session #
MSDA Medicaid CHIP State Dental Association 2015 Na(onal Medicaid and CHIP Oral Health Symposium Session # Integra(ng Oral and General Healthcare Bruce Donoff, DMD, MD Washington Marrio4 Wardman Park Tuesday,
More informationBeen there, done it, got the T- shirt: Life in Med Comms. Stephen Paterson Freelance Med Comms Specialist
Been there, done it, got the T- shirt: Life in Med Comms Stephen Paterson Freelance Med Comms Specialist Ques?ons, ques?ons... Who am I? Why am I talking to you today? What am I going to talk about? Why
More informationSECTION 1: ABOUT HEPATITIS
SECTION 1: ABOUT HEPATITIS Hepa33s means swollen liver Many things can cause your liver to become swollen, including drinking a lot of alcohol; taking certain medica3ons or herbs; inhaling toxic fumes;
More informationOtis W. Brawley, MD, FACP
The Transformation of American Medicine (A Cancer Prospective) Otis W. Brawley, MD, FACP Chief Medical and Scientific Officer American Cancer Society Professor of Hematology, Medical Oncology, Medicine
More informationContact tracing in international travel: A German national prospective study. Preliminary results and case example
Contact tracing in international travel: A German national prospective study Preliminary results and case example Benedikt Greutélaers Robert Koch Institute, Surveillance Unit CAPSCA, 19.06.2013 Content
More informationNutri&on And Diete&c Services in The Context to Chronic Kidney Disease (CKD) And The Need of Diasporic Engagement
Nutri&on And Diete&c Services in The Context to Chronic Kidney Disease (CKD) And The Need of Diasporic Engagement Dr. Nahlaa Khalifa Clinical Nutri,on Department, Faculty of Applied Medical Sciences, King
More informationIntroduction to Microbes and Infectious Disease
Name: Date: Introduction to Microbes and Infectious Disease Station 1) Pathogens Pathogens are capable of causing. Examples: Station 3) Discovery My name is Anton von Leeuwenhoek, and in I documented my
More informationdeclara&ons Clostridium difficile infec&on. Time to wake up and smell the..., um, nevermind. OK, next slide please. Bruce Dalton, BScPhm. PharmD.
Clostridium difficile infec&on. Time to wake up and smell the..., um, nevermind. OK, next slide please. Bruce Dalton, BScPhm. PharmD. declara&ons No financial disclosures Personal acquaintance, co- worker,
More informationEvolu)on of drug resistance. The evolu)on of drug resistance. 1. Forms of resistance: Resistance to drugs. 1. Forms of resistance: Resistance to drugs
The evolu)on of drug resistance Drug resistance describes the ability of a parasite or pathogen to overcome our a9empts to control them. Drug resistance has evolved to become a worldwide health threat.
More informationDevelopmental Screening and Electronic Health Records (EHRs)
The findings and conclusions in the presenta3on are those of the presenters and do not necessarily represent the official posi3on of the Centers for Disease Control and Preven3on Developmental Screening
More informationReaching Men with Community Outreach. Peris Urasa National AIDS Control Programme, Tanzania 6 November 2018
Reaching Men with Community Outreach Peris Urasa National AIDS Control Programme, Tanzania 6 November 2018 Ministry of Health, Community Development, Gender, Elderly and Children Na;onal AIDS Control
More informationPrac%ced based research networks and evidenced based den%stry : A bridge to help close the research to prac%ce gap. Southwest Region Annual Mee8ng
Prac%ced based research networks and evidenced based den%stry : A bridge to help close the research to prac%ce gap. Southwest Region Annual Mee8ng Miami, Fl. Febuary 21, 2014 Paul Benjamin DMD, MAGD, FACD
More informationOverview of European Consumption Databases
FEDERAL INSTITUTE FOR RISK ASSESSMENT Overview of European Consumption Databases Katrin Büsch Workshop Food Consumption Data and Dietary Exposure in the European Union, 15-16 May 2008, Berlin Introduction
More informationDDD / 1000 inhabitants /day. Where are antibiotics given?
DDD / 1000 inhabitants /day Where are antibiotics given? DDD per 1000 inhabitants per day (2010) 40 35 30 25 20 15 10 5 0 Greece Luxembourg Beelgium France Italy Iceland Portugal Malta Poland Ireland Spain
More informationUTILIZATION OF ONCOTYPE DX TO GUIDE TREATMENT FOR EARLY STAGE BREAST CANCER. Rosemary Cress, DrPH
UTILIZATION OF ONCOTYPE DX TO GUIDE TREATMENT FOR EARLY STAGE BREAST CANCER Rosemary Cress, DrPH June 16, 2015 Introduction Therapy for women with early stage breast cancer typically includes, surgery
More informationLAI: Linee guida ed esperienze internazionali
LAI: Linee guida ed esperienze internazionali LAI: Guidelines and interna5onal experience PM Llorca CHU Clermont-Ferrand EA 7280 Université Clermont Auvergne Disclosures Advisory board: Allergan, Jansen,
More informationAntibiotic Consumption in the Community in Ireland REPORT FOR First Half of 2013
Antibiotic Consumption in the Community in Ireland REPORT FOR First Half of 2013 1 Summary: Community Antibiotic Use The rate for Quarter 1 of 2013 (1 st January to 31 st March) was 27.4 Defined Daily
More informationWHO posi)on paper on hepa))s A vaccines
WHO posi)on paper on hepa))s A vaccines Geneva, Switzerland Published in the Weekly Epidemiological Record on 13 July 2012 Transmission and incidence Hepa))s A virus (HAV) is transmiled primarily via the
More informationOral Health Need in North Dakota
Oral Health Need in North Dakota Shawnda Schroeder, PhD Kris6n Schuller, PhD Ken Hall, JD Center for Rural Health WORKING PRESENTATION: DATA PRESENTED on 6.24.2014 Established in 1980, at The University
More informationHEPATITIS C BASICS ILAN S. WEISBERG, MD DIRECTOR HEPATOLOGY LENOX HILL HOSPITAL JUNE 20, 2015
HEPATITIS C BASICS ILAN S. WEISBERG, MD DIRECTOR HEPATOLOGY LENOX HILL HOSPITAL JUNE 20, 2015 Overview Understand the GLOBAL and US burden of chronic HCV infec
More informationRisk Assessment in IPC. Key Defini>ons. Risk Assessment in IPC
Dr Nizam Damani MSc, MBBS, FRCPath., FRCPI, CIC, DipHIC Associate Medical Director Infec>on Preven>on and Control Southern Health & Social Care Trust, Portadown, UK Senior Lecturer, Queen s University,
More informationHHS. Hyperglycaemic Hyperosmolar State Care Pathway 1 Presenta8on to 6 hours. Page 1 of 2 AFFIX PATIENT LABEL ! INFORM DIABETES TEAM OF ADMISSION!
Hyperglycaemic Hyperosmolar State Care Pathway 1 Presenta8on to 6 hours Page 1 of 2 Time of Arrival Loca8on Date / / Diagnosis the characteris8c features of a person with HHS are a) Hypovolaemia b) Marked
More informationUpdate on Adult Immunizations and Recommendations
Update on Adult Immunizations and Recommendations NMSHP BALLOON FIESTA MEETING OCTOBER 4, 2015 JENNIFER BLAKE, PHARMD BCPS CLINICAL PHARMACY SUPERVISOR, VA MEDICAL CENTER Objectives - Pharmacist Describe
More informationNEGLECT, ABUSE AND VIOLENCE IN LATER LIFE:
NEGLECT, ABUSE AND VIOLENCE IN LATER LIFE: INTERSECTIONALITY OF GENDER AND AGE Competing Paradigms of Elder Abuse: Learning from Intimate Partner Abuse, Active Aging, and Vulnerable Older Adult Research
More informationA large database study in the general population in England
Time-dependent markers of comorbidity severity and change are associated with increased risk of mortality in heart failure: A large database study in the general population in England Claire A. Rushton,
More informationSponsored by Virox Technologies Inc. C. difficile 101 A brief review of guidelines and controversies
Controlling Clostridium difficile Outbreaks: Going Beyond the Guidelines Michael Gardam Infec
More informationFebriDx. FebriDx is a rapid, in- office test that
FebriDx 1 FebriDx FebriDx is a rapid, in- office test that uses a fingers;ck blood sample to iden;fy and differen;ate a clinically significant immune response to viral and/or bacterial acute respiratory
More informationEffec&ve Messaging for Suicide Preven&on:
Effec&ve Messaging for Suicide Preven&on: Anara Guard anara@suicideispreventable.org Lessons from a statewide campaign and from a na&onal framework This morning The Know the Signs statewide social marke&ng
More informationThe Effec(veness of Peer Support Services: Highlights from the Research. BRSS TACS Webinar August 18, :00-3:30 PM Eastern Time
1 The Effec(veness of Peer Support Services: Highlights from the Research BRSS TACS Webinar August 18, 2016 2:00-3:30 PM Eastern Time 2 Webinar Moderator Jus(ne Hanson Center for Social Innova2on Webinar
More informationUNCONSCIOUS BIAS What is it? Sponsored by InDemand Interpre1ng
1 UNCONSCIOUS BIAS What is it? 2 Unconscious Bias: What is it? How does it work? By: David B. Hunt, J.D. President and CEO, Cri8cal Measures Awareness: New Research Regarding Bias 3 In the past, bias was
More informationR x. for Preven+on. Ross Aikins, Ph.D. Stacy Andes, MA, Ed.D. American College Health Associa=on Annual Mee=ng 2011 June 1, 2011
R x for Preven+on Ross Aikins, Ph.D. Stacy Andes, MA, Ed.D. American College Health Associa=on Annual Mee=ng 2011 June 1, 2011 1 Learning Objec+ves Discuss current research on college student non- medical
More informationClinical Evidence in the Daily Work of an Anthroposophic Hospital Dr. med. Harald Matthes, Medical Director, Havelhöhe Hospital in Berlin
Programme Venue: Time: Chair: Presentations: Members Salon, European Parliament 8:00 9:30 am Marian Harkin MEP Research Evidence in Homeopathy: Overview of published clinical investigations Robert Mathie
More information