Foundation year 1 doctors and clinical pharmacology and therapeutics teaching: A retrospective view in light of experience

TY - JOUR

T1 - Foundation year 1 doctors and clinical pharmacology and therapeutics teaching

T2 - A retrospective view in light of experience

AU - Tobaiqy, Mansour

AU - McLay, James

AU - Ross, Sarah

PY - 2007/9

Y1 - 2007/9

N2 - What is already known about this subject • In the UK prescribing-related errors are common. • Poor prescribing and prescribing errors result in significant patient morbidity and mortality. • In hospital, junior doctors are responsible for a significant number of prescribing errors. What this study adds • Only 8% of foundation year (FY) 1 doctors rate their knowledge of clinical pharmacology as good and 30% as poor or worse. Aims To determine whether, in retrospect, first year foundation (FY1) programme doctors believe that their undergraduate education in Clinical Pharmacology and Therapeutics (CPT) has prepared them to prescribe safely and rationally. Methods This was a prospective questionnaire survey. Ninety FY1 doctors, employed in the Aberdeen Teaching Hospitals, participated. Results Seventy-one percent of FY1 doctors completed the survey. Thirty percent of respondents rated their knowledge of CPT as poor or worse and only 8% as good; 74% reported having witnessed an adverse drug reaction (ADR) and 55% a drug–drug interaction, a number of which had resulted in patient morbidity or mortality. Many of these events were reported to have been avoidable or predictable with more extensive undergraduate and postgraduate training. Forty-two percent of respondents stated that they had not been taught enough about avoiding ADRs and 60% about avoiding drug–drug interactions during their undergraduate years. Over 75% of respondents reported high levels of confidence for the unsupervised use of warfarin, nonsteroidal analgesics and opiate analgesics. In retrospect, FY1 doctors would like more undergraduate teaching in prescribing for special patient groups, ADRs, drug interactions, together with CPT in their postgraduate teaching programme. Conclusions FY1 doctors believe that their undergraduate and postgraduate training in CPT is insufficient to prescribe safely and rationally. This study adds further weight to the call for an increase in the training of junior doctors in the rational and safe use of medicines. • The majority of FY1 doctors reported themselves confident to prescribe medicines associated with high levels of patient morbidity and mortality. • Potentially avoidable adverse drug reactions and drug interactions were reported by 60–75% of FY1 doctors, many of which were reported to have been avoidable with more extensive undergraduate training. • FY1 doctors would like more focused undergraduate teaching on the avoidance of adverse drug reactions and drug–drug interactions, together with increased clinical pharmacology and therapeutics in their postgraduate training programme.

AB - What is already known about this subject • In the UK prescribing-related errors are common. • Poor prescribing and prescribing errors result in significant patient morbidity and mortality. • In hospital, junior doctors are responsible for a significant number of prescribing errors. What this study adds • Only 8% of foundation year (FY) 1 doctors rate their knowledge of clinical pharmacology as good and 30% as poor or worse. Aims To determine whether, in retrospect, first year foundation (FY1) programme doctors believe that their undergraduate education in Clinical Pharmacology and Therapeutics (CPT) has prepared them to prescribe safely and rationally. Methods This was a prospective questionnaire survey. Ninety FY1 doctors, employed in the Aberdeen Teaching Hospitals, participated. Results Seventy-one percent of FY1 doctors completed the survey. Thirty percent of respondents rated their knowledge of CPT as poor or worse and only 8% as good; 74% reported having witnessed an adverse drug reaction (ADR) and 55% a drug–drug interaction, a number of which had resulted in patient morbidity or mortality. Many of these events were reported to have been avoidable or predictable with more extensive undergraduate and postgraduate training. Forty-two percent of respondents stated that they had not been taught enough about avoiding ADRs and 60% about avoiding drug–drug interactions during their undergraduate years. Over 75% of respondents reported high levels of confidence for the unsupervised use of warfarin, nonsteroidal analgesics and opiate analgesics. In retrospect, FY1 doctors would like more undergraduate teaching in prescribing for special patient groups, ADRs, drug interactions, together with CPT in their postgraduate teaching programme. Conclusions FY1 doctors believe that their undergraduate and postgraduate training in CPT is insufficient to prescribe safely and rationally. This study adds further weight to the call for an increase in the training of junior doctors in the rational and safe use of medicines. • The majority of FY1 doctors reported themselves confident to prescribe medicines associated with high levels of patient morbidity and mortality. • Potentially avoidable adverse drug reactions and drug interactions were reported by 60–75% of FY1 doctors, many of which were reported to have been avoidable with more extensive undergraduate training. • FY1 doctors would like more focused undergraduate teaching on the avoidance of adverse drug reactions and drug–drug interactions, together with increased clinical pharmacology and therapeutics in their postgraduate training programme.

UR - http://europepmc.org/abstract/med/17506779

U2 - 10.1111/j.1365-2125.2007.02925.x

DO - 10.1111/j.1365-2125.2007.02925.x

M3 - Article

C2 - 17506779

SN - 0306-5251

VL - 64

SP - 363

EP - 372

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

IS - 3

ER -