title: Effect of structural animal health planning on antimicrobial use and animal health variables in conventional dairy farming in the Netherlands.
abstract: Widespread veterinary use of antimicrobials might contribute to the increasing burden of antimicrobial resistance. Despite many successful efforts to reduce veterinary antimicrobial use in the Netherlands, antimicrobial use on a substantial number of farms has remained relatively high over the past few years. Farm-specific solutions are required to further lower antimicrobial use on these farms. Reducing the burden of animal diseases at the farm level by means of a structured approach to animal health planning could be promising. This intervention study aimed to evaluate the main effects of an animal health planning program developed by an advisory team consisting of a dairy farmer, his veterinarian, and his feed adviser under the guidance of a professional facilitator. During an initial farm visit, the advisory team developed a farm-specific animal health planning program with support from the facilitator. After 1 yr, the effects of this program on animal health, production parameters, and antimicrobial use were evaluated and compared with control farms that did not have a facilitated animal health planning program. Antimicrobial use on intervention farms was significantly reduced between the start and the end of the study period; however, no significant differences in the rate of reduction between the intervention and control groups could be observed (-19% and -14%, respectively). Reduced antimicrobial use did not result in negative effects on animal health and production parameters during the study period in both groups. On intervention farms, a significant positive relationship was found between the percentage of completed action points at farm level and the percentage reduction in antimicrobial use. The level of compliance with action points and the quality of collaboration between farmer and advisers were positively associated with the accomplishment of corresponding objectives. However, the total number of objectives was negatively associated with the level of compliance with action points and tended to be negatively associated with the percentage reduction in antimicrobial use at farm level. Gradually reducing antimicrobial use without adverse effects on animal health and productivity is possible by adjusting management practices in a team effort. Fostering good collaboration among farmer, veterinarian, and feed adviser and focusing on a limited number of objectives have positive effects on the outcomes of the animal health planning program and antimicrobial use.
authors.affiliation: Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, PO Box 80165, 3508 TD Utrecht, the Netherlands. Electronic address: d.c.speksnijder@uu.nl.
authors.forename: David C
authors.initials: DC
authors.lastname: Speksnijder
authors.affiliation: Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, PO Box 80165, 3508 TD Utrecht, the Netherlands.
authors.forename: Haitske
authors.initials: H
authors.lastname: Graveland
authors.affiliation: Eijck Interim Management, 8219 AM Lelystad, the Netherlands.
authors.forename: Ineke A J M
authors.initials: IAJM
authors.lastname: Eijck
authors.affiliation: Schepers Adviseurs, 7201 AV Zutphen, the Netherlands.
authors.forename: René W M
authors.initials: RWM
authors.lastname: Schepers
authors.affiliation: Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands.
authors.forename: Dick J J
authors.initials: DJJ
authors.lastname: Heederik
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
authors.forename: Theo J M
authors.initials: TJM
authors.lastname: Verheij
authors.affiliation: Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, PO Box 80165, 3508 TD Utrecht, the Netherlands; Wageningen Bioveterinary Research, PO Box 65, 8200 AB Lelystad, the Netherlands.
authors.forename: Jaap A
authors.initials: JA
authors.lastname: Wagenaar
mesh_terms: D026683:Advisory Committees / Q000458:organization & administration*; D000818:Animals; D000900:Anti-Bacterial Agents; D003612:Dairying; D017723:Drug Utilization Review / Q000458:organization & administration*; D006285:Health Planning / Q000458:organization & administration*; D009426:Netherlands; D015397:Program Evaluation; D018634:Veterinarians
chemical_list: D000900:Anti-Bacterial Agents
keywords: antimicrobial use; continuous improvement; facilitated animal health planning; implementation