Department of Geriatric Medicine, Department of Clinical Pharmacology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Maastricht University, Maastricht, the Netherlands.
Br J Clin Pharmacol. 2021 Aug;87(8):3268-3278. doi: 10.1111/bcp.14747. Epub 2021 Mar 5.
Junior doctors frequently prescribe incorrectly and this can cause serious harm to patients. Pharmacotherapy education in most medical schools falls short in preparing their students to prescribe safely in clinical practice. According to the theory of assessment-driven learning, a pharmacotherapy self-assessment for junior doctors may reduce potential harmful prescriptions in clinical practice, by revealing deficits in prescribing knowledge and skills.
In this single centre, prospective cohort study, the potential harmful prescriptions of junior doctors in clinical practice were compared before and after a pharmacotherapy self-assessment with and without additional pharmacotherapy education.
Potential harmful prescriptions best known to cause harm to patients were studied in all the prescriptions written out by 199 junior doctors in the first 2 months of their employment in our hospital. The pharmacotherapy self-assessment reduced the total number of potential harmful prescriptions made by junior doctors relative to those made by junior doctors in the control group (1.3 vs. 3.2%, respectively; P < .001). Additional education did not reduce potential harmful prescriptions beyond the effect of the self-assessment alone (1.3 vs. 1.0%, P > .05).
Pharmacotherapy self-assessment leads to fewer potential harmful prescriptions made by junior doctors in clinical practice, thereby improving patient safety. More research is needed to investigate whether additional pharmacotherapy education strategies reduce potential harmful prescriptions further.
实习医生经常开具不正确的处方，这可能会对患者造成严重伤害。大多数医学院的药物治疗学教育在培养学生安全处方方面做得不够，无法满足临床实践的需要。根据评估驱动学习理论，对实习医生进行药物治疗自我评估可能会通过发现处方知识和技能方面的不足，减少临床实践中潜在的有害处方。
在这项单中心前瞻性队列研究中，我们比较了在药物治疗自我评估前后，以及是否额外进行药物治疗教育，实习医生在临床实践中开具的潜在有害处方。
在我们医院工作的前 2 个月内，对所有实习医生开具的处方中最容易对患者造成伤害的潜在有害处方进行了研究。药物治疗自我评估使实习医生开具的潜在有害处方总数相对于对照组（分别为 1.3%和 3.2%；P <.001）减少。额外的教育并没有在自我评估的基础上进一步减少潜在的有害处方（1.3%比 1.0%，P >.05）。
药物治疗自我评估可减少实习医生在临床实践中开具的潜在有害处方，从而提高患者安全性。还需要进一步的研究来调查是否有其他药物治疗教育策略可以进一步减少潜在的有害处方。
