Tobaiqy Mansour, McLay James, Ross Sarah
Department of Medicine and Therapeutics, The University of Aberdeen, Aberdeen, UK.
Br J Clin Pharmacol. 2007 Sep;64(3):363-72. doi: 10.1111/j.1365-2125.2007.02925.x. Epub 2007 May 15.
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.
This was a prospective questionnaire survey. Ninety FY1 doctors, employed in the Aberdeen Teaching Hospitals, participated.
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.
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.
回顾性地确定一年级基础培训(FY1)项目的医生是否认为其本科阶段的临床药理学与治疗学(CPT)教育使他们能够安全、合理地开处方。
这是一项前瞻性问卷调查。阿伯丁教学医院聘用的90名FY1医生参与了调查。
71%的FY1医生完成了调查。30%的受访者将他们的CPT知识评为差或更差,只有8%评为好;74%的人报告曾目睹药物不良反应(ADR),55%的人报告目睹过药物相互作用,其中一些导致了患者发病或死亡。据报告,通过更广泛的本科和研究生培训,许多此类事件本可避免或可预测。42%的受访者表示,本科期间关于避免ADR的内容他们学得不够,60%的受访者表示关于避免药物相互作用的内容学得不够。超过75%的受访者表示对在无监督情况下使用华法林、非甾体类镇痛药和阿片类镇痛药有很高的信心。回顾过去,FY1医生希望本科教学中增加针对特殊患者群体开处方、ADR、药物相互作用方面的内容,以及在研究生教学计划中增加CPT方面的内容。
FY1医生认为他们在CPT方面的本科和研究生培训不足以安全、合理地开处方。这项研究进一步支持了增加初级医生合理安全用药培训的呼声。