United Kingdom

Veterinary Diagnostic Practice and the challenge of Antimicrobial Resistance

Will a better understanding of veterinary diagnostic practices and of the possible role of rapid and innovative diagnostic technology help in the drive to reduce the overall use of AMs in livestock farming and thus help decrease AM resistance amongst both animal and human pathogens?  The Universities of Bristol, Exeter and Edinburgh are currently collaborating in a major study entitled 'Diagnostic Innovation and Livestock: Towards more effective and sustainable applications of antibiotics in livestock farming’ (DIAL).  As part of that research, in association with the BVA, and following on from World Antibiotics Awareness Week, we are carrying out a large scale on-line survey of UK farmed animal veterinarians, which will be live from 21st November to 16th December 2018.   

The Challenge

The O’Neill Review in 2015 identified a need for the greater use of diagnostic tools in veterinary medicine to identify and confirm infection and disease and thereby make more targeted and appropriate prescription and treatment decisions involving antimicrobials in livestock agriculture. To achieve this, better understanding is needed of how diagnostics are currently used in veterinary practice and of what opportunities and barriers might exist for new, innovative and more rapid diagnostic technologies.

The Research

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The DIAL research project, which has been funded by the Economic and Social Research Council working in partnership with the Department of Health, DEFRA and others, involves a four-year interdisciplinary collaboration between veterinary scientists, social scientists, natural scientists and veterinarians to map out the different conditions (behavioural, regulatory, economic and physical) that impact upon diagnostic processes and tests and can foster innovation in the development and use of diagnostic tools in the United Kingdom. To achieve this, we are examining current diagnostic tools and processes and, in particular, how these inform decisions leading to the use of antimicrobials in animal treatment.  At the same time, we are reviewing the current use of rapid or point-of-care diagnostic tools in livestock veterinary medicine with a view to identifying the potential for new rapid devices to contribute to more targeted antimicrobial use.

The Survey

The survey of UK large animal veterinarians that we are carrying out with the collaboration of the BVA, is being sent to all farmed animal veterinarians who are currently members of the BVA and/or the Speciality Divisions (Association of Government Veterinarians, Association of Veterinarians in Industry, BCVA, British Veterinary Poultry Association, Pig Veterinary Society, Society of Practising Veterinary Surgeons, Veterinary Public Health Association). It is an on-line survey, with respondents answering through a web-link to a dedicated site. The survey has four aims:

•       To generate data on the current use of diagnostics in farm animal veterinary medicine

•       To investigate the relationship between diagnostic practice and the use of antimicrobials in livestock treatment;

•       To assess the current use and future potential of pen-side, on-farm, point-of-care and rapid diagnostics in farm animal veterinary medicine and;

•       To consider the potential for future improvements and developments in rapid diagnostic tools to achieve better targeting and more appropriate use of antimicrobials in the treatment of farm animals.

The questionnaire takes around 15 minutes to complete and we are hoping that a large number of farmed animal veterinarians will be able to respond.  The survey is entirely anonymous, and all respondents have been assured that the information they supply will be only used for research purposes by the research team.  We are very much hoping for a strong response rate from BVA and/or Speciality Division members. As the latest VAARS Report demonstrates, the veterinary profession in the UK, along with the farming profession, have already achieved considerable success in reducing antimicrobial use in livestock.

Who we would like to participate in the survey

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We are hoping to get responses from veterinarians who are regularly dealing with farmed animals as their principal veterinarian activity, whether they are private veterinarians, self-employed, independent or working in a corporate practice, veterinarians associated with food and feed companies or other bodies, government or academic veterinarians. We are seeking responses from veterinarians working with all the main farmed species: including dairy cattle, beef cattle, poultry (layers), poultry (boilers) and pigs.

What happens with the survey results?

The survey will be open for three weeks whereupon we shall begin to analyse the results.  Because all the data recorded is entirely anonymous and no individual or organisation will be identified or identifiable from the results, we are looking to establish patterns of variation in the responses (for example, in the types of diagnostic tool favoured by particular groups of veterinarians) and associations between answers (for example, a positive answer in one question being associated with a negative answer in another). We are looking to review the most comment diagnostic tools employed and their perceived limitations. We also want to find out how veterinarians in practice use rapid diagnostic tools, if they do, and what potential they believe such tools might have in contributing to more targeted medicine use.  The results will be published at the completion of the research, but we are fully intending to share early results of the survey with BVA and, hopefully, will be able to report those findings, in a later contribution to the BVA blog site.

Beyond the Survey

This survey is part of a broader 4-year research project on diagnostics and antimicrobial use in farm animal veterinary medicine. In addition to the survey run in collaboration with BVA, we are talking to vets and farmers across the country about the processes and procedures employed or followed when determining whether an animal, or herd or flock is infected with a bacterial disease or infection and the prescription and treatment decisions that flow from that determination.  We are working with the developers of diagnostic tools as well as the regulators and policy-makers who determine whether a particular tool gets to the market. We are working with veterinarians who experiment with new diagnostic procedures and we hope, as part of this research, to actively test new diagnostic tools within farm environments.  Finally, we are also conducting parallel research in Tanzania, where we believe rapid diagnostics may well have a significant role to play in disease management and treatment where veterinary infrastructure is less widespread.

If any BVA members and/or questionnaire respondents would like any additional information about the DIAL project, about the questionnaire survey or would simply like to talk to us about their own use of diagnostic tools or their opinions on rapid diagnostics, please do not hesitate to contact the DIAL research team or go to our website.

https://www.dialamr.com/what-we-do/

DIAL Team at Bristol Vet School:             Contact Alison Bard on alison.bard@bristol.ac.uk

DIAL team at the University of Exeter:  Contact Ray Chan on K.Chan2@exeter.ac.uk

The DIAL Project Research Team: 

Kristen Reyher, David Barrett, Alison Bard (Bristol Veterinary School)

Henry Buller, Stephen Hinchliffe, Ray Chan (Exeter University)

Joyce Tait, Ann Bruce, Katie Adam (Edinburgh University)