Department of Internal Medicine, Unit Pharmacotherapy, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.
Br J Clin Pharmacol. 2023 Apr;89(4):1431-1451. doi: 10.1111/bcp.15606. Epub 2022 Dec 8.
Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate medical curriculum. To support CP&T education, it is important to determine which drugs medical undergraduates should be able to prescribe safely and effectively without direct supervision by the time they graduate. Currently, there is no such list with broad-based consensus. Therefore, the aim was to reach consensus on a list of essential drugs for undergraduate medical education in the Netherlands.
A two-round modified Delphi study was conducted among pharmacists, medical specialists, junior doctors and pharmacotherapy teachers from all eight Dutch academic hospitals. Participants were asked to indicate whether it was essential that medical graduates could prescribe specific drugs included on a preliminary list. Drugs for which ≥80% of all respondents agreed or strongly agreed were included in the final list.
In all, 42 (65%) participants completed the two Delphi rounds. A total of 132 drugs (39%) from the preliminary list and two (3%) newly proposed drugs were included.
This is the first Delphi consensus study to identify the drugs that Dutch junior doctors should be able to prescribe safely and effectively without direct supervision. This list can be used to harmonize and support the teaching and assessment of CP&T. Moreover, this study shows that a Delphi method is suitable to reach consensus on such a list, and could be used for a European list.
由于许多刚毕业的医生缺乏处方能力，因此初级医生在临床实践中经常出现处方错误。这在一定程度上是由于本科医学课程中临床药理学和治疗学（CP&T）的教育不足。为了支持 CP&T 教育，确定医学生在毕业时无需直接监督即可安全有效地开哪些药物非常重要。目前，还没有这样一份具有广泛共识的清单。因此，本研究旨在就荷兰本科医学教育的基本药物清单达成共识。
在来自所有八所荷兰学术医院的药剂师、医学专家、初级医生和药物治疗学教师中进行了两轮改良 Delphi 研究。要求参与者表明，医学生毕业后能够开出初步清单上包含的特定药物是否至关重要。所有受访者中≥80%同意或强烈同意的药物被纳入最终清单。
共有 42 名（65%）参与者完成了两轮 Delphi 研究。初步清单中的 132 种药物（39%）和两种新提出的药物（3%）被纳入其中。
这是第一项确定荷兰初级医生无需直接监督即可安全有效地开出的药物的 Delphi 共识研究。该清单可用于协调和支持 CP&T 的教学和评估。此外，本研究表明，Delphi 方法适用于就此类清单达成共识，并且可以用于制定欧洲清单。
