The Happy Patient project starts to investigate how inappropriate use of antibiotics should be reduced  

Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) indicate that in 2015 around 33,000 deaths were attributable to antibiotic resistance. And that by 2050 it could reach 10 million deaths.

The project is funded by the 3rd EU-Funded Health Program. Happy Patient is led by the Institut Català de la Salut (ICS) and the Fundació Institut Universitari per a la recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol). Likewise, it has the presence of the Spanish Society of Family and Community Medicine (semFYC) as leader of the communication strategy, and with the University of Las Palmas de Gran Canaria (ULPGC) and the Fundación Canaria Parque Científico Tecnológico de la ULPGC as leader in the evaluation of the strategy and with the University Institute of Patients of the International University of Catalonia (UIC) as patient care research organization ..

The World Health Organization warns that many of the drugs that work today will cease to be effective in the coming years if the use and prescription of antibiotics is not rationalized at all levels of health care.

It is imperative to implement a successful strategy to reduce antibiotic use, which can be adapted and implemented in a wide range of different prescribing systems and cultures.

The HAPPY PATIENT project is made up of 16 scientific, university and clinical organizations from 8 European countries (Spain, France, Germany, the Netherlands, Poland, Lithuania, Greece, Denmark and Norway) and has been created as a response from the European Commission to address the growth of antimicrobial resistance (AMR) in the last 20 years. The notable Spanish participation in the project is based on the leadership of the Institut Català de la Salut and the Institut d’Investigació per a l’Atenció Primària Jordi Gol, who will coordinate the European project; Dr. Carles Llor, family doctor in Barcelona Primary Care and ICS (Institut Català de la Salut), coordinator of the project, is a researcher with long experience in European research on the proper use of antibiotics and resistance bacterial. On the other hand, the University of Las Palmas de Gran Canaria and its Technological Park Foundation will be in charge of evaluating the project results; and the International University of Catalonia will act as Patient Care research organization, that is, it will be in charge of working in close contact with patient organizations. While the Spanish Society of Family and Community Medicine (semFYC) will be in charge of the communication strategy given its experience with professional groups and with scientific dissemination to the general public. The project will begin its work today and tomorrow with a launch meeting that will be virtual. 

"The inappropriate use of antibiotics is the main driver of the growing development and spread of antimicrobial resistance"

"The current prescription of antibiotics is one of the greatest threats to Western societies"

"75% of doctors in Europe today do not know in depth the consequences of resistance to these drugs"

Carles Llor:"Faced with the global COVID-19 pandemic, people with respiratory diseases are being treated with antibiotics around the world, without this having an impact on improving their health or eliminating the virus"

During the next 3 years Happy Patient will investigate the needs and realities of each of these countries and adapted training strategies and materials in the countries where the most antibiotics are prescribed: Spain, France, Greece and Poland; and Lithuania, whose consumption data is in the lowest part of the European ranking. The objective is to prevent by up to 40% the incorrect and massive prescription of antibiotics at the different levels of health care. Those responsible for the project argue that "after two decades of effort to address the growth of antimicrobial resistance (AMR), the urgency of the problem is now even greater. Inappropriate use of antibiotics is the main driver of development and spread. Increasing Antimicrobial Resistance ". So much so that data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) show that in 2015 around 33,110 deaths were attributable to antimicrobial resistance, while by 2050 that figure could reach 10 million.

Doctors and female doctors, and patients of the first level of care, together with nurses, as well as dentists and other specialties in Secondary Care, pharmacists and nursing homes will be the target audience of this project. The research centers will play a relevant role in analyzing the data and preparing data for the different planned interventions.

The current prescription of antibiotics is one of the greatest threats to Western societies, as the European section of the WHO has warned on several occasions. According to data provided by the European Center for Disease Prevention and Control (ECDC), up to 25,000 people die on average each year in Europe as a direct consequence of the misuse of antibiotics, a figure that rises to 30,000 in the United States.

The increase in mortality related to the resistance of microorganisms is reaching alarming levels in many other parts of the world due, among other circumstances, to the massive use of these drugs in animals as a consequence of the industrialization of meat production processes.

Last year 2019, the first survey carried out among healthcare workers was published, in which 18,000 professionals in 24 EU countries participated. In it, their knowledge about the use and resistance of antibiotics was evaluated and it was concluded that 75% of doctors in Europe do not know in depth today the consequences of resistance to these drugs.

Antibiotics and COVID-19: a dangerous relationship

Although for now there are no relevant studies that have linked higher mortality from COVID-19 to a national history of poor prescription of antibiotics, those responsible for HAPPY PATIENT, led by family doctor and researcher Carles Llor, coincide in highlighting that an immune system excessively exposed to antibiotics is in a worse condition to cope with a new virus for which there are no defenses. In the words of C. Llor himself, "a greater number of complications in patients exposed to prolonged use of antibiotics are foreseeable, especially in the context of nursing homes, where the use of antibiotics is close to being arbitrary".

Scientist Carles Llor warns that "in the face of the global COVID-19 pandemic, people with respiratory diseases are being treated with antibiotics all over the world, without this having an impact on improving their health or eliminating the virus", and considers that "if at this time we can speak of a decrease in the prescription of antibiotics at the European level, it is not thanks to a change in pharmacological practice, but rather to a collateral consequence of confinements, which have prevented close contact with patients" . Llor also believes that "the COVID-19 pandemic may be a unique opportunity to wipe the slate clean in the customs and automatisms of antibiotics that too many health professionals turn to when they have to navigate the seas of diagnostic uncertainty "..

High rates of resistance in urinary tract infections, sepsis, sexually transmitted infections, and some forms of diarrhea

One of the most important tasks in the fight against antibiotic resistance is to classify antimicrobial resistance one by one and on a case-by-case basis. In this regard, common bacterial infections, including urinary tract infections, sepsis, sexually transmitted infections, and some forms of diarrhea, are known to have high rates of resistance to antibiotics, which are frequently used as treatment, around the world. A resistance rate to ciprofloxacin, an antibiotic commonly used to treat urinary tract infections, was found between 8.4% and 92.9% in Escherichia coli and between 4.1% and 79.4% in klebsiella pneumoniae, as recently reported by the Global Antimicrobial Use and Resistance Surveillance System (GLASS).

In another order of diseases, antibiotic-resistant strains of Mycobacterium are already a real threat in containing the global epidemic of tuberculosis. WHO estimates that in 2018 there were around half a million new cases of rifampicin-resistant tuberculosis (RR-TB) identified globally. As for MDR-TB tuberculosis, it has also been found to be resistant to the two most powerful anti-tuberculosis drugs ever created. Less than 60% of those treated for MDR / RR-TB were successfully cured.

The Project

HAPPY PATIENT will implement a patient-centered approach, involving healthcare professionals, who act as first points of contact with the healthcare system and are responsible for the management of community-acquired infections. The healthcare professionals who will participate in the HAPPY PATIENT project are:

• Primary health care service providers, such as family doctors, nurses and dentists/li>
• Emergency meds
• Health professionals in residences
• Pharmacists

The project work will make available practices and materials for the interaction between health professionals and patients in terms of understanding and implementation of a more responsible prescription and use of antimicrobials for human consumption. As a result, there will be ongoing impact through the immediate ability to locate and scale products nationally, regionally and locally.

Happy Patient Partners

The Happy Patient Project Consortium is made up of the IDIAPJGol Research Institute and the Institut Català de la Salut (ICS), the University of Copenhagen (UCPH), the University of Southern Denmark (SDU) and its Odense General Practice Research Unit (RUPO), the Norwegian Research Center (NORCE), the Capital Region of Denmark, the Rijksuniversiteit Groningen (RUG), the University of Las Palmas de Gran Canaria (ULPGC) and Fundación Canaria Parque Científico Tecnológico de la Universidad de Las Palmas de Gran Canaria (FCPCT), the Nice University Hospital (CHU de Nice), My Family Doctor (Mano Seimos Gydytojas), the Medical University of Lodz (MUL)), the University of Crete (UoC), the Spanish Society of General Practitioners (SEMFYC), the European Association of Clinical Pharmacology (EACPT), the Center Hospitalier Universitaire de Rennes (CHU Rennes) and the International University of Catalonia - Institute of Patients (UIC).

More information: https://happypatient.eu/