Citation, summary and comments from me below.
CITATION: Using digital health technologies to optimise antimicrobial use globally
Timothy M Rawson, PhD timothy.rawson07@imperial.ac.uk ∙ Nina Zhu, PhD ∙ Ronald Galiwango, PhD ∙ Derek Cocker, PhD ∙ Mohammad Shahidul Islam, PhD ∙ Ashleigh Myall, PhD∙ et al.
SUMMARY
Digital health technology (DHT) describes tools and devices that generate or process health data. The application of DHTs could improve the diagnosis, treatment, and surveillance of bacterial infection and the prevention of antimicrobial resistance (AMR). DHTs to optimise antimicrobial use are rapidly being developed. To support the global adoption of DHTs and the opportunities offered to optimise antimicrobial use consensus is needed on what data are required to support antimicrobial decision making. This Series paper will explore bacterial AMR in humans and the need to optimise antimicrobial use in response to this global threat. It will also describe state-of-the-art DHTs to optimise antimicrobial prescribing in high-income and low-income and middle-income countries, and consider what fundamental data are ideally required for and from such technologies to support optimised antimicrobial use.
COMMENTS (NPW):
1. We know that antibiotics are massively overprescribed, and newer 'blockbuster' drugs are especially misused, driving resistance.
2. We know that there is a lack of up-to-date and relevant medicine information in low and lower middle ncome settings, including for antibiotics, as found by our HIFA systematic review (in association with LSHTM and Nagasaki University) 'How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries: a systematic review.' https://www.hifa.org/sites/default/files/publications_pdf/BMJGlobalHealt...
3. We know that information on when and what antibiotic to use in each clinical situation is especially hard to find (as compared with information on individual antibiotics).
4. We know that ‘Globally, most prescribers receive most of their prescribing information from the pharmaceutical industry and in many countries this is the only information they receive.’ (This is from the WHO World Medicines Report 2011, and there is no evidence that the situation has improved)
5. We know that the pharmaceutical industry is driven by profit and there are strong commercial pressures for health professonals to prescribe more antibiotics, and to prescribe newer more expensive antibiotics that drive resistance ever faster.
What is needed is to understand and address the information needs of prescribers and users of antibiotics, especially with regards to rational prescribing. And solutions need to be available in primary-care low-resource settings.
We are currently inviting proposals and ideas for new HIFA Projects in 2025. We have a team standing ready to address the above issues: https://www.hifa.org/projects/prescribers-and-users-medicines
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
