Restricting access to antibiotics: The effectiveness of a 'no repeats' government policy intervention

Juliet Contreras; Victor Oguoma; Lyn Todd; Mark Naunton; Peter Collignon; Mary Bushell

doi:10.1016/j.sapharm.2023.02.009

Restricting access to antibiotics: The effectiveness of a 'no repeats' government policy intervention

Res Social Adm Pharm. 2023 May;19(5):800-806. doi: 10.1016/j.sapharm.2023.02.009. Epub 2023 Feb 19.

Authors

Juliet Contreras¹, Victor Oguoma², Lyn Todd³, Mark Naunton⁴, Peter Collignon⁵, Mary Bushell⁶

Affiliations

¹ Faculty of Pharmacy, University of Canberra, ACT, Australia. Electronic address: Juliet.Contreras100@gmail.com.
² Health Research Institute, University of Canberra, ACT, Australia. Electronic address: Victor.Oguoma@canberra.edu.au.
³ Faculty of Pharmacy, University of Canberra, ACT, Australia. Electronic address: Lyn.Todd@canberra.edu.au.
⁴ Faculty of Pharmacy, University of Canberra, ACT, Australia. Electronic address: Mark.Naunton@canberra.edu.au.
⁵ ANU Medical School, ANU College of Health & Medicine, ACT, Australia; Australian Capital Territory Pathology, Canberra Hospital, Garran, Australian Capital Territory, Australia. Electronic address: peter.collignon@act.gov.au.
⁶ Faculty of Pharmacy, University of Canberra, ACT, Australia. Electronic address: Mary.Bushell@canberra.edu.au.

PMID: 36828673
DOI: 10.1016/j.sapharm.2023.02.009

Abstract

Background: Australia has a high rate of antibiotic use. Government policy interventions are one strategy to optimise the use of antibiotics. On 1 April 2020, the Australian Government Department of Health introduced a policy intervention to increase the quality use of four antibiotics.

Objectives: To assess if the government policy intervention improved the appropriate supply of the four antibiotics amoxicillin, amoxicillin-clavulanic acid, cefalexin and roxithromycin.

Method: This study employed a retrospective cohort study design comparing a 10% sample (n = 345,018) of four antibiotics prescribed and dispensed in Australia during a three-month period (May, June, July) in 2019, and again in 2020 (after the policy intervention). The 10% sample of PBS data was obtained from the Australian Government Department of Health. Descriptive statistics, bivariate and multivariable logistic regression analysis were carried out.

Results: The results suggest the policy change improved the appropriate supply of original prescriptions in 2020 compared to 2019 OR = 1.75 (95% CI = 1.68-1.82, p < 0.001), and appropriate supply of repeat prescriptions OR = 1.56 (95% CI = 1.25-1.96, p < 0.001). In 2020, the proportion of appropriate supply of original prescriptions increased by an absolute difference of 1.8% (95% CI = 1.6-1.9%; P < 0.001), and appropriate supply of repeat prescriptions increased by 3.9% (95% CI = 2.2-5.5%; P < 0.001). The total number of antibiotic prescriptions prescribed and dispensed in 2019 (N = 219,960) reduced in 2020 (N = 125,058) after the policy intervention.

Conclusion: The study provides evidence for the impact of a government policy intervention to improve the appropriate supply of antibiotics, although some of the reduction in antibiotic use was likely due to the concomitant COVID-19 pandemic. Further research is required to assess the impact of the intervention outside a pandemic.

Keywords: AMS; Antibiotics; Government policy change; Pharmaceutical benefits scheme.

MeSH terms

Anti-Bacterial Agents* / therapeutic use
Australia
COVID-19*
Government
Humans
Pandemics
Policy
Retrospective Studies

Substances

Anti-Bacterial Agents