Akici A, Kalaça S, Gören M Z, Akkan A G, Karaalp A, Demir D, Uğurlu U, Oktay S
Department of Pharmacology and Clinical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey.
Eur J Clin Pharmacol. 2004 Apr;60(2):75-82. doi: 10.1007/s00228-004-0751-2. Epub 2004 Mar 20.
The aim of this study was to compare rational pharmacotherapy decision-making competency of interns (final-year medical students) who had received rational pharmacotherapy education (RPE), with their classmates at another medical school and general practitioners (GPs) who had not been exposed to RPE.
A written, objective, structured clinical examination (OSCE), consisting of open and structured questions, was given to all participants. The participants were expected to make a treatment plan and prescribe for simple, uncomplicated beta-hemolytic streptococcal tonsillitis and mild-to-moderate essential hypertension patients, explain their proposed treatment plans and reasons affecting their drug choice. After the OSCE, a questionnaire to assess knowledge of the rational use of drugs was given to the participants.
Fifty RPE(+) interns, 54 RPE(-) interns and 53 GPs participated in the study. Mean scores of RPE(+) interns were higher than those of GPs, which were in turn found to be higher than those of RPE(-) interns for all cases. The RPE(+) interns scored the highest regarding all components of rational pharmacotherapy process for all cases of both indications. However, participants in all groups had higher scores for the structured questions compared with the corresponding open ones for both diseases. Prescription analysis also revealed better results for RPE(+) interns regarding the number of drugs/prescription and treatment costs.
The present study demonstrated that the final-year medical students (interns) markedly benefited from undergraduate RPE at the medical school in developing rational prescribing skills compared with their classmates from a medical school with traditional pharmacology education. Interestingly, they got higher scores than not only RPE(-) interns, but also than the GPs participating in this study, indicating the urgent need for continuous medical education programs in this field throughout the country for practicing GPs.
本研究旨在比较接受过合理药物治疗教育（RPE）的实习生（医学专业最后一年的学生）与另一所医学院的同学以及未接受过RPE的全科医生（GPs）在合理药物治疗决策能力方面的差异。
对所有参与者进行了一项书面的、客观的、结构化临床考试（OSCE），包括开放式和结构化问题。要求参与者为单纯性、非复杂性β溶血性链球菌扁桃体炎和轻至中度原发性高血压患者制定治疗计划并开出处方，解释他们提出的治疗计划以及影响药物选择的原因。OSCE结束后，向参与者发放了一份评估合理用药知识的问卷。
50名接受过RPE的实习生、54名未接受过RPE的实习生和53名全科医生参与了该研究。在所有病例中，接受过RPE的实习生的平均得分高于全科医生，而全科医生的得分又高于未接受过RPE的实习生。在两种适应症的所有病例中，接受过RPE的实习生在合理药物治疗过程的所有组成部分得分最高。然而，对于两种疾病，所有组的参与者在结构化问题上的得分均高于相应的开放式问题。处方分析还显示，接受过RPE的实习生在药物数量/处方和治疗费用方面的结果更好。
本研究表明，与接受传统药理学教育的医学院同学相比，医学专业最后一年的学生（实习生）在医学院接受本科RPE后，在培养合理处方技能方面明显受益。有趣的是，他们不仅比未接受过RPE的实习生得分高，而且比参与本研究的全科医生得分高，这表明全国范围内迫切需要为执业全科医生开展该领域的继续医学教育项目。
