Two of the Island’s junior doctors – Ben Lambden and Mustafa Jaafar – are developing a new smartphone app to assist with antibiotic prescribing on the wards of Noble’s Hospital.
The development will be funded by a £4,000 prize won by the doctors in a Dragons’ Den competition held annually by Health Education North West.
The den contained five eminent dragons at director, chief executive and postgraduate dean level from across the North West of England’s NHS.
The app will guide doctors through a prescribing process or ‘decision tree’ specifically tailored to Noble’s Hospital’s antibiotic prescription protocols. No patient data will be used by the app. Instead it will use generic details of a patient’s symptoms and test results to determine the most appropriate and effective antibiotic to prescribe. It means that the app can be installed on any compatible device without having to link to the hospital’s IT systems. This advantage gives scope for easy deployment in other hospitals in the UK and further afield.
Dr Jaafar said:
'I saw the Dragons’ Den competition advertised and approached fellow junior doctor Ben Lambden and our colleague Dr Matthew Todd to see if they were interested in taking part. As doctors we are all too aware of the threat posed by antibiotic resistance and we all have a role to play in tackling it.
'Dr Lambden had previously carried out an audit of antibiotic stewardship at Noble’s Hospital, which showed there was room for improvement in how we diagnosed specific infections and prescribed these drugs. We decided examine how we could help address that problem as quickly, easily and cost effectively as possible.
'The British National Formulary has developed an app which is effectively an encyclopaedia on medicines. But it is not intelligent, meaning that it doesn’t help to guide doctors through the prescribing process. We decided to explore the possibility of developing an app that could do just this – including the immediate printing of a prescription – but specifically for antibiotics as the issue of tackling resistance is so important. We wanted our app to help doctors to prescribe the most appropriate antibiotics in a busy ward environment, consistently, quickly and efficiently, whilst also reducing the possibility for human error.'
The issue of antimicrobial resistance is a growing global issue. The World Health Organisation conducted global surveillance in 2014, analysing data from 114 countries. Reviewing seven common bacteria that cause serious diseases and infections, high levels of resistance to antibiotics were found in all regions of the world. The build-up of resistance has become a serious issue because no new major antibiotics have been discovered for over 30 years. To help address the situation the famous Longitude Prize last year set the challenge of how to tackle antibiotic resistance, with a £10 million prize fund. The UK also commissioned the Review on Antimicrobial Resistance to examine ways of tackling drug resistant infections.
Dr Lambden said:
'In July 2014 UK Prime Minister David Cameron spoke of a world ‘cast back into the dark ages of medicine’, so serious is the threat and challenge of treating disease without effective antibiotics.
'Prescribing the right antibiotic for a particular condition or infection means that microbes are less likely to survive and therefore don’t have the opportunity to adapt. That’s why completing a full course of antibiotics is so important.
'To prescribe the most appropriate antibiotic doctors need to have as much information as possible about the microbes causing the infection. This means analysing symptoms carefully and conducting tests where appropriate. All too often broad-spectrum antibiotics are prescribed which are capable of treating a wide variety of infections. However by doing this there’s a risk that the most effective weapons in the armoury aren’t being utilised. Overuse and dependence on particular antibiotics increases the likelihood of microbes surviving and adapting to build up their resistance.'
Dr Adrian Dashfield, Director of Medical Education at Noble’s Hospital, said:
'We are very proud of Drs Jaafar and Lambden. It says a great deal about the quality of junior doctors that the Island attracts, and of our medical education programme, that Ben and Mustafa have beaten competition from across the North West region of England to win this prize.'
Doctors Lambden and Jaafar complete their second year foundation training in July and will leave the Island to continue their post-graduate education, but they are hopeful of having the new app up and running before their departure.
Dr Matthew Todd, supervisor of the project and Consultant Nephrologist at Noble’s Hospital, said:
'We’ll be encouraging the next intake of junior doctors to carry on Ben and Mustafa’s work by repeating the antibiotic stewardship audit next year. The results of this will help us to determine if the app has been a success in helping doctors to make effective clinical decisions and therefore improve patient care.'
Health Education North West is responsible for the training of doctors in the region, including the Isle of Man. Noble’s Hospital is one of 10 acute teaching hospitals in the Cheshire and Merseyside area. Each year 24 post-graduate or ‘junior’ doctors come to the Isle of Man to complete the first and/or second year of their Foundation Training Programme.
