A Qualita)ve Approach to Explore Mo)va)ons for An)microbial Prescribing by Veterinary Surgeons in UK Pig Prac)ce

Transcription

1 A Qualita)ve Approach to Explore Mo)va)ons for An)microbial Prescribing by Veterinary Surgeons in UK Pig Prac)ce Lucy Coyne, Dr Sophia Latham, Dr Nicola Williams, Dr Rob Smith, Prof Susan Dawson, Richard Pearson and Dr Gina Pinchbeck h"p:// / common_infec<ons_will_be_untreatable_if_an<bio< c_misuse_con<nues.html h"p:// /Life- wont- be- the- same- without- an<bio<cs.html

2 Background Why consider anamicrobial prescribing pacerns in pigs? AnAmicrobial resistance is a growing problem in human and veterinary medicine Influences and drivers in human prescribing have been extensively invesagated QuanAtaAve research suggests that similar drivers may influence prescribing in food producing animals h"p:// jun/11/is- rise- farm- an<bio<c- use- threat- h"p://s.telegraph.co.uk/graphics/projects/ an<bio<c- resistance/index.html

3 Qualita)ve Research Methods - Focus Groups and In- depth Interviews QualitaAve research methods allowed the comparison of different paracipants moavaaons behind anamicrobial use in pigs. Two focus groups were held in two geographically disanct areas - moderate and high pig density areas Twenty one in- depth semi- structured interviews were completed across England and Scotland Purposive sampling aimed to cover the spectrum of the UK pig industry

4 Qualita)ve Research Methods ThemaAc Analysis Transcripts were transcribed verbaam and anonymised Data segments were coded in transcripts and categorised into meaningful minor themes Transcripts were coded using the qualitaave data management tool Atlas.A (ATLAS.A ScienAfic SoZware Development). These minor themes were found to link and common subject areas were exposed and categorised as major themes Further analysis was carried out looking at how commonly themes occurred, and examining minority and majority opinion

5 Results Major themes idenafied as moavaaons behind anamicrobial prescribing decisions in pigs Agricultural Factors Disease Epidemiology and Outcomes Drug- related Factors Economic Factors External Pressures Knowledge Base h"p://qz.com/122774/chinas- farms- are- joining- its- hospitals- in- churning- out- an<bio<cs- resistant- superbugs/#122774/ chinas- farms- are- joining- its- hospitals- in- churning- out- an<bio<cs- resistant- superbugs/ Responsibility Vet- client RelaAonship

6 Results Exploring major themes Agricultural Factors I think the hardest thing in pig produc<on at the moment is obviously, as I said earlier, an<bio<cs are used as a management tool (Interview) Outdoor Breeding Sows Indoor Breeding Sows SlaCed Finishing AccommodaAon Photograph - David Levene Source - Straw- based Finishing AccommodaAon Source RaClerow Farms Ltd. Source -

7 Results Exploring major themes Disease Epidemiology and Outcomes you can t nego<ate with a bug sorry they don t understand nego<a<on (Focus Group) Drug- related Factors I obviously prefer water medica<on I am more confident that the pigs are geung the correct dose with in- feed medica<on you never quite know who is geung what, a sick pig won t eat. (Interview) I try to stop them using Fluoroquinolones except when they need to. and I m fairly allergic to Naxcel [CeYiofur], you ll be pleased to hear. (Interview)

8 Results Exploring major themes Economic Factors If farmer s could re- invest in new and be"er buildings. That would drive down an<bio<c dependency there isn t enough profitability to re- invest (Focus Group) External Pressures I m very aware of the poli<cs and the pressure surrounding an<microbial use and resistance (Interview) Knowledge Base if you re the veterinary prac<<oner you know the farm, you know the history of that farm, you know the other problems on that farm (Interview)

9 Results Exploring major themes Responsibility most resistance comes from humans so what they re really saying is that we ve got resistance problems with fluoroquinolones and third and fourth genera<on cephalosporins in hospitals, so to make us feel be"er we ll stop vets using it (Interview) Vet- Client Rela)onship Rela<onship in the vet farmer client is very important. As it is sort of with people it s something that the government and people can t measure (Interview)

10 Discussion Overview of what influences anamicrobial prescribing behaviours in pig vets Theme saturaaon achieved by focus groups and in- depth interviews QualitaAve research methods offer in- depth insight into paracipants percepaons that are not possible through quanataave research methods Common drivers idenafied in anamicrobial prescribing in human medicine and current study looking at moavaaons in pig pracace Further work will consider farmer s percepaons on anamicrobial use

11 Conclusions Pigs presently contribute the largest proporaon towards the sale of single species anamicrobial products in food producing animals in the UK It is essenaal that the responsible use of anamicrobials in food producing animals is advocated to safeguard their future efficacy in human and veterinary medicine Understanding the prescribing behaviours of veterinary surgeons will allow effecave intervenaons to be developed where overprescribing or inappropriate use is considered a problem h"p://ec.europa.eu/food/dyna/conference/

12 Acknowledgements All of the vets who have given their Ame and consideraaon to the project.