AS patients with enthesitis constitute a more severe subset of disease, and the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index is feasible and reliable for measurement of this condition. Discrimination requires further study in larger trials.

Objectives: Due to concerns about both costs and drug resistance, reducing antibiotic prescribing is a strategic aim for the UK National Health Service. A nationwide public education campaign launched in October 1999 (CATNAP) addressed this. The objectives were 1) to assess public attitudes to antibiotic use in a district with high antibiotic prescribing where a nationwide public education campaign was locally enhanced, 2) to assess the impact of the campaign on prescribing of antibiotics locally. Design: 1) Questionnaire survey to test the hypothesis that public attitudes would be equivalent before and after local enhancement of the national campaign. Responses to all general questions were equivalent in both surveys. There was considerable misunderstanding amongst the population about the effectiveness of antibiotics, particularly in relation to viral infections, colds, sore throats and coughs. The proportion of responders who believed that children should be prescribed antibiotics for a fever was not equivalent in the two surveys, it decreased from 56 to 49%, the limit of the one-sided confidence interval was 13.5%. 2) The rate of change in prescriptions dispensed between 1998/9 and 1999/2000 was not sigdicantly different from that expected, based on the previous four years, in either England and Wales or Barking and Dagenham. Conclusion: Using this study design and this method of locally enhancing a public education campaign, the locally enhanced campaign did not appear to influence the public's attitudes towards antibiotic prescribing in an area of high prescribing. Assessment of the attitudes of those who had definitely been exposed to the campaign and greater promotion of the campaign and its messages to, and by, GPs might be more likely to produce a demonstrable change in attitudes.

Conclusions: The all-island CHD Network is a linked group of health professionals and organisations from primary, secondary and tertiary care, working in a coordinated manner, to ensure equitable provision of high quality, clinically effective services to this complex cohort of patients

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