A survey of UK prescribers' experience of, and opinions on, anthelmintic prescribing practices for livestock and equines.

The aim of this study was to determine practices, attitudes and experiences of UK prescribers of anthelmintics for horses and livestock. A questionnaire was sent by direct email to groups licenced to prescribe these medicines. These were veterinarians, Suitably Qualified Persons (SQPs, registered with the Animal Medicines Training Regulatory Authority) and veterinary pharmacists. The survey was also advertised through social media. It comprised questions relating to demographics, training experiences, current prescribing practices, as well as personal opinions on anthelmintic selection, diagnostics and anthelmintic resistance. A total of 193 veterinarians and 326 SQPs were included in final analysis. Pharmacists were excluded from detailed analysis due to the low numbers that responded (n=3). The results indicated that SQP participants were more likely to receive post-certification parasitology training than the veterinarians, and that both channels consulted similar sources for information about helminths and their control (paper articles in journals, online sources). The SQP participants stated a higher frequency of face-to-face interactions with clients/customers (96.1%) than the veterinarians (76.4%), who stated a higher frequency of telephone interactions (55.1% and 73.5%, respectively). Veterinarians were more likely to state that there were specific factors that limited interactions with their clients (54.1%) than SQPs (19.6%), such as competition from other suppliers. SQP participants considered a wider range of factors as important when deciding on which anthelmintic to recommend (i.e. knowledge of specific parasites, knowledge of specific anthelmintics, discussion of measures to avoid anthelmintic resistance and time to talk with clients/customers); however, the veterinarian participants were more likely to consider the results of diagnostic tests. While discussions about anthelmintic resistance were stated with similar frequency in both groups, less frequent were specific discussions about anthelmintic sensitivity testing. In-house faecal egg count analysis was more likely to be available from those that prescribed anthelmintics for equines alone, compared to prescribers who dispensed anthelmintics for livestock alone or livestock and equines. The SQP participants indicated that they felt a large number of organisations were responsible for ensuring that anthelmintics are used responsibly, whilst veterinarian participants were more likely to place responsibility on the prescribers alone. Taken together, these findings provide an insight into how prescribers of anthelmintics in the UK interact with their clients/customers before and at the point of sale and act as a unique source of information on how best practice advice pertaining to sustainable helminth control is disseminated by the various prescribing channels.

Use of a multiple choice questionnaire to assess UK prescribing channels' knowledge of helminthology and best practice surrounding anthelmintic use in livestock and horses.

Grazing livestock and equines are at risk of infection from a variety of helminths, for which the primary method of control has long been the use of anthelmintics. Anthelmintic resistance is now widespread in a number of helminth species across the globe so it is imperative that best practice control principles be adopted to delay the further spread of resistance. It is the responsibility of all who prescribe anthelmintics (in the UK, this being veterinarians, suitably qualified persons (SQPs) and pharmacists) to provide adequate information on best practice approaches to parasite control at the point of purchase. Poor uptake of best practice guidelines at farm level has been documented; this could be due to a lack of, or inappropriate, advice at the point of anthelmintics purchase. Therefore, the aim here was to evaluate levels of basic knowledge of helminthology, best practice guidelines and dispensing legislation among veterinarians and SQPs in the UK, through a Multiple Choice Question (MCQ) test, that was distributed online via targeted emails and social media sites. For each respondent, the percentage correct was determined (for the MCQ test overall and for subsections) and the results analysed initially using parametric and non-parametric statistics to compare differences between prescribing channels. The results showed that channels generally performed well; veterinarians achieved a mean total percentage correct of 79.7% (range 34.0-100%) and SQPs, a mean total percentage correct of 75.8% (range 38.5-100%) (p=0.051). The analysis indicated that veterinarians performed better in terms of knowledge of basic helminthology (p=0.001), whilst the SQP group performed better on legislation type questions (p=0.032). There was no significant difference in knowledge levels of best practice between the two channels. Multivariable linear regression analysis showed that veterinarians and those answering equine questions only performed significantly better than those answering all questions. Based on information gaps identified by analysis of individual questions, a number of areas for improvement in knowledge transfer to both channels are suggested to improve the quality of advice at the point of anthelmintics purchase.