Beekeeping for the Future 2017 Duane Landals B.Sc.Ag. DVM Senior Advisor Alberta Veterinary Medical Association
Antibiotic Use In Beekeeping Part 3 Antimicrobial Use Culture Shift: the Impact on Beekeepers
Antibiotic Use In Beekeeping : Part 3 Public Health Agency of Canada: Surveillance Stewardship Innovation Infection Prevention and Control
Health Canada Veterinary Drug Directorate: Remove growth promotion claims for antimicrobials used in animal feed (will come into effect during 2017) Enhance veterinary oversight in antimicrobial use in food producing animals, including medicated feeds(this will require all medically important antimicrobials to be by veterinary prescription only regardless of route of administration) Regulatory control in own use importation and use of active pharmaceutical ingredients food animals
STEWARDSHIP: CAREFUL AND RESPONSIBLE MANAGEMENT OF SOMETHING ENTRUSTED TO ONE S CARE Antimicrobials are no longer viewed as a commodity that can be purchased but rather as property of society that may be used only under social license.
Veterinary Oversight mandates the implementation of good Stewardship Practices Veterinary Oversight is a professional responsibility of veterinarians Veterinary Medicine is regulated under provincial legislation Registration/Licensure of all veterinary practice is a requirement of law
VETERINARY OVERSIGHT OF ANTIMICROBIAL USE PROFESSIONAL STANDARDS FOR VETERINARIANS (Abridged version for the use of the Canadian Council of Veterinary Registrars)
Objectives of Veterinary Oversight: Eliminate unnecessary antimicrobial use Improve standards of use where necessary Improve animal health to reduce need for antimicrobials Overall reduction of use of antimicrobials in animal health Improve consumer and public confidence Maintain access to essential animal health medications Protect public health/safety Meet phyto-sanitary standards involving animal trade
Veterinarians Role: Determination of medical need for treatment Provide written direction for treatment detailing the specific drug, dosage and duration of medication Distribution of or direction of distribution of product Use or advise on use of product post distribution Veterinary Client Patient Relationship
Veterinarians Role: Document in medical record Participate in legitimate surveillance programs Engage with clients on health and management strategies that reduce the need for antimicrobials Consider the importance of a product in human medicine before deciding on a specific course of medication
Pan-Canadian Framework for Professional Standards for Veterinarians To provide a template for provincial licensing bodies to develop consistent practice standards regarding provision of veterinary oversight in the use of antimicrobials for veterinarians across Canada
Issues Addressed: Common understanding of Veterinary Client Patient Relationship (VCPR) Differentiating; Prescribing and Dispensing Transparency is prescribing and dispensing and the potential conflict of interest Extra Label Drug use by veterinarians Need for education
Veterinary Client-Patient Relationship: registered veterinarian has assumed the responsibility for making medical judgments regarding the health of a person s animals and the need for medical treatment the client has agreed to follow the instructions of the veterinarian
Veterinary Client-Patient Relationship: the registered veterinarian has sufficient knowledge of a person s animals so that : the registered veterinarian may initiate at least a general or preliminary diagnosis of the medical condition of the animals by virtue of : an examination of the animals, by medically appropriate and timely visits to the premises where the animals are kept or by both examination and visits
Veterinary Client-Patient Relationship: the registered veterinarian is readily available for followup care in case of adverse reactions to, or failure of, the regimen of therapy provided by the veterinarian for a person s animals
The requirements to be met by the registered veterinarian in order to appropriately prescribe a drug include: Establish and meet conditions of a valid Veterinarian Client Patient Relationship (VCPR) in regards to the specific animal or group of animals, Make an evidence-based determination of medical need, Complete appropriate documentation in the medical record, Provide oversight of use and follow up
The Situation: All medically important antimicrobials will require a veterinary prescription before they can be dispensed The conditions of a VCPR must be met before a veterinarian issues a prescription Dispensing is a regulated professional activity limited to pharmacists and veterinarians
Concerns: Establishing a valid VCPR Veterinary Client Relationship: what information is needed on a medical record? Veterinary Patient Relationship: is a farm visit or an examination of an animal needed to establish medical need? interactions may include, but are not limited to: farm or home visits, clinic appointments, consultations, direct animal examinations (individual or herd/flock), laboratory reports, production record reviews
Concerns: Access to products once a prescription has been generated The acts of prescribing and dispensing are commonly performed as an integrated activity in veterinary practice A registered veterinarian who has determined the medical need and appropriately issued a prescription must provide a copy of this prescription to the client if the client requests to access the medication from a legitimate source other than the prescribing veterinarian
Concerns: Extra Label Use of Antimicrobials in Minor Species Veterinarians may prescribe a Health Canada approved product (veterinary or human) for a species, at a dose or for an indication not on the label, provided there is no suitable on-label product available. It is recognized that ELDU is necessary to protect health and welfare in minor use species
Concerns: Education and Training of Veterinarians development of information packages for practitioners following the lines of our previous experience in Alberta (Tylosin) establish continuing education opportunities for veterinarians and beekeepers (perhaps jointly) e.g. CanWest enhanced undergraduate education in DVM programs (current full rotation in apiculture being offered at WCVM for senior students, 20/year and oversubscribed) support and expand research and innovation in bee health (such as recent three year research scholarship for PhD student at WCVM in area of bee colony health)
Thank You for your attention! Questions?