Investigator(s)
| WHO Technical Officer |
Richard Clive Brown WHO Thailand Office Richard Clive Brown 
|
| Principal Investigator |
Anond Kulthanmanusorn IHPP Anond Kulthanmanusorn
|
Title(s) and abstract
| Scientific title | Development of Antimicrobial Use Monitoring System in Bangkok Primary Care Units |
| Public title | Development of Antimicrobial Use Monitoring System in Bangkok Primary Care Units |
| Background | Optimizing use of antimicrobials is one of the key strategies in addressing antimicrobial resistance (AMR) in Thailand. In parallel of antimicrobial use (AMU) monitoring system in healthcare facilities, understanding knowledge, attitudes, and practices of healthcare professionals and enabling system for antimicrobial stewardship (AMS) are crucial for the design of effective AMS interventions in healthcare facilities. |
| Objectives | This study aims to quantify antimicrobial use among primary care units (PCU) in Bangkok, to compare AMU in different primary care, to assess determinants of AMU and AMS practices in public health center (PHC) and to provide recommendations advocating practical policies to promote AMS in primary care units under Universal Coverage Scheme (UCS) in Bangkok. |
| Study Methods | The National Health Security Office (NHSO)’s routine reimbursement database will be explored for AMU monitoring. In terms of data analysis, descriptive and analytical cross-sectional studies will be conducted. A study population will be outpatient services provided to members of UCS who visited public and private primary care units in Bangkok. One full year of NHSO’s reimbursement database between 1 April 2021 and 31 March 2022 will be studied. The antibiotic prescription and defined daily dose (DDD) of listed antimicrobial agents will be described by patient characteristic, month, principal diagnosis, comorbidity, medication, location, type of primary care facility, irrational use, and revisit episode. DDD per 1000 inhabitants per day (DID) will be calculated for each facility. Then a comparison between PHCs and private clinics will be made. All prescriptions in all primary care facilities in each district and region will be analyzed together using all AMU measurements. An online survey on knowledge, attitude, and practice (KAP) on AMR and AMU of primary care providers and supporting system will be conducted following a semi-structure interview. Analysis will be done by descriptive statistic. Transcription and field notes will be analyzed using content analysis method. |
| Expected outcomes and use of results | Measurement of AMU and understanding of AMS practices in primary care facilities in BKK could inform policy makers about AMU and AMS situation in this area. This project could contribute to the design of specific AMS intervention in urban settings. Furthermore, AMU monitoring and AMS in primary care setting are key strategic actions addressed in the National Strategic Plan on Antimicrobial Resistance Phase 2 (2023-2027). This project would support the Ministry of Public Health to achieve the national plan’s targets. |
| Keywords | antimicrobial stewardship, antimicrobial resistance, antimicrobial use, primary care |
Research Details
| Student research | No |
| Start Date | 01-May-2023 |
| End Date | 31-Dec-2023 |
| Key Implementing Institution | International Health Policy Program |
| Multi-country research | No |
| Nationwide research | No |
| Thailand | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | |
| Involves human subjects | Yes |
| Health System and Policy Research | |
| Data Collection | Primary and secondary data |
| Proposal reviewed by other Committee | Final decision available |