The first virtual workshop of Europe’s first AMR Patient Group entitled, ‘Addressing antimicrobial resistance and healthcare associated infections through patient empowerment’ took place on Wednesday 16 December 2020 from 10:00 to 12:30 Brussels time. The purpose of the workshop was to provide participants with a comprehensive overview of the issues of antimicrobial resistance (AMR) and healthcare associated infections (HAIs), the state of play in Europe, and discussion around the best approach we can take to tackle these deeply concerning problems at the patient-level. The workshop was moderated by Laura Cigolot from Health First Europe (HFE) and participants were given presentations from high-level speakers as well as opportunities to raise questions and have an open discussion to further the group’s mission and objectives.
Ms Cigolot opened the virtual workshop on behalf of HFE, outlining the purpose and mission statement of the new AMR Patient Group: to educate and raise patient awareness about AMR, to build a consistent patient voice on AMR across Europe, and to broaden the AMR debate to include infection prevention control measures.
The first presentation was given by Dr Dominique L Monnet, Head of Disease Programme, Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) at the European Centre for Disease Control (ECDC). Dr Monnet gave a comprehensive overview of AMR to help participants understand all the areas that AMR encompasses. Interestingly, Dr Monnet said he prefers not to use the ‘AMR’ acronym himself as it makes the concept too abstract. Dr Monnet’s presentation also provided case studies and the latest Eurosurveillance statistics on AMR from Europe, which are all available on the ECDC website. He advised on the most effective AMR prevention methods, which included the prudent use of antimicrobial agents and good hand hygiene practices. Dr Monnet noted the ongoing studies into the effects of the Covid-19 pandemic on antimicrobial resistance.
The second speaker was Dr Massimo Sartelli from Macerata Hospital in Italy. Dr Sartelli presented the workshop with an excellent overview of infection prevention and control measures from a clinical perspective. Participants learned the incidence rates of HAIs, how they are contracted in healthcare settings and best practices to help avoid them. Dr Sartelli highlighted that hands are the most common vehicle to transmit health care-associated pathogens, and the necessity of strict hand hygiene practices. His key message was that hand hygiene is a simple and effective solution to protect patients from HAIs and to reduce both the spread of infection and multi-resistant germs.
Ms Annabel Seebohm, Secretary General of the Standing Committee of European Doctors (CPME) was the third speaker to take the floor. Ms Seebohm’s presentation centred around the role of doctors in fighting AMR at the primary care level. She noted that doctors in primary care settings are on the frontline of efforts to improve the responsible use of antibiotics and it is paramount that they promote and implement the prudent use of antibiotics, i.e., only when needed, in correct dose intervals and in correct duration. Ms Seebohm also highlighted the CPME’s policy recommendations to Member States and doctors across Europe to help streamline a European approach to prescribing antibiotics responsibly, as well as CPME’s active engagement in promoting the ‘One Health’ approach, which looks at AMR prevention from an interdisciplinary perspective (i.e., an approach which combines the medical, dental, animal and environmental sectors).
Finally, Ms. Seebohm provided participants with an overview of what European doctors know about antibiotics and antibiotic resistance based on the latest statistics from the ECDC. Optimistically, more than 70% of doctors agreed to having good opportunities to provide advice on prudent use of antibiotics to patients, however 45% of doctors said they have insufficient time and no resources available for not being able to give out advice or resources to patients. Ms Seebohm emphasised that these figures show that not only do we need action in terms of developing guidelines and strategies on the prudent use of antibiotics, but also in the organisation of primary care so that doctors have sufficient time and resources to properly share information with patients.
Ms Emma Kollatou, Manager of Government Affairs and Public Policy at MedTech Europe spoke next about the role of medical technologies in the fight against AMR and HAIs. Ms Kollatou emphasised how medical technologies can help fight AMR throughout the patient pathway, from prevention to diagnosis, to controlling infection spread through tracking and monitoring to stop the spread of resistant bacteria. In her presentation, Ms Kollatou spoke in particular about how In Vitro Diagnostics can help patients at the community level by differentiating between a viral and bacterial infection, and at the hospital level through faster diagnosis which leads to more timely and appropriate treatement and better patient outcomes. In all, medical technologies can help society as a whole through more accurate infection diagnoses which will help to ensure the efficacy and prudent use of antibiotics for generations to come.
Among her recommendations, Ms Kollatou noted that at the European level, the joint action group EU-JAMRAI is coming to an end soon, which means there is a need for joint-action guidelines to be issued. She echoed Ms Seebohm’s call to engage with the ‘One Health’ approach, and also advocated for promoting a prevention culture.
The final speaker of the workshop was Ms Sian Williams, Policy and Advocacy Adviser at Wellcome Trust, UK. Ms Williams talked about the political will on AMR, warning that although it is strong, it is still at risk. She highlighted how we can help to reinforce a mandate for change through collective action, which requires better understanding of antimicrobial resistance at the public level. However, awareness alone is not enough to spark collective action and behavioural change, but rather, people may need a deeper connection to the issue in order to bring about real change. Ms Williams provided the participants with knowledge on how to approach effective patient education and messaging on AMR based on the latest research.
Framing is key in public education on AMR, and Ms Williams advised the Patient Group members on key framing advice from the Wellcome Trust, which included the recommendation that the fundamentals of AMR should be explained succinctly. AMR needs to be emphasised as a universal issue that is solvable, but which requires immediate action. She also highlighted the power of human-focused patient stories and noted the opportunity that the AMR Patient Group provides to encourage patient voices within AMR advocacy.
The workshop included questions and answers sessions and open group discussion where we heard from our members about their concerns regarding AMR and the biggest issues they face as patient representative groups. From the discussion, a recurring issue was raised regarding the difference in approach to antibiotics regulations across borders. This concern further added weight to recommendations that were heard from multiple speakers to adopt a joint ‘One Health’ approach to AMR in Europe at the political, medical and community policy action levels. The work of EU-JAMRAI needs to be carried forward into the future. Overall, the group was in agreement that patients tend to trust their doctors and healthcare professionals, and education on AMR needs to come from all levels. Patients can be both leaders and supporters in the fight against AMR.
In terms of messaging on AMR, the most effective approach is evidence-based and simple messaging, with a focus on human stories to aid understanding and encourage collective action. Ms Sian Williams also gave a prudent example of why AMR concepts need to be clearly explained: many people do not realise that the “resistance” element of AMR applies to the bacteria or microbe, and not to the person themself. This understanding enables people to see that AMR is not an individual or personal problem, but a global community health crisis. Another key recommendation that came from the workshop was the necessity of educating children and their parents to ensure the next generation has a full understanding of the concepts relating to AMR and effective infection prevention measures, especially that of good hand hygiene practices. The effects of the Covid-19 pandemic on AMR rates are still unknown and may overall be contextual. However, it is crucial that good hygiene practices remain into the future and that the importance of AMR action must stay firmly on the global health agenda. The first workshop successfully laid out the groundwork and tools needed to succeed in achieving the AMR Patient Group mission: to educate and raise patient awareness about AMR, to build a consistent patient voice on AMR across Europe, and to broaden the AMR debate to include infection prevention control measures.
To conclude this event summary, here is a great analogy that our AMR Patient Group member Neda Milevska-Kostova from the International Alliance of Patients’ Organizations (IAPO) contributed to the workshop: “Antibiotics are like a fire extinguisher. You need to have one, but you hope you never need to use it”.