Assessment of prescription writing skills among undergraduate medical students

Authors

  • M. J. Sudha Associate Professor, Department of Pharmacology,Department of Anatomy, Azeezia Institute of Medical Sciences, Kollam, Kerala, India
  • S. Viveka Associate Professor, Department of Anatomy, Azeezia Institute of Medical Sciences, Kollam, Kerala, India
  • S. Remya Associate Professor, Department of Pharmacology,Department of Anatomy, Azeezia Institute of Medical Sciences, Kollam, Kerala, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20162477

Keywords:

Prescription writing, Curriculum change, Medical undergraduates, Clinical discussion

Abstract

Background: The existing medical undergraduate curriculum includes training in prescription writing in second phase under pharmacology and Therapeutics. This study evaluates the prescription writing skills of undergraduate medical students and interns and need for emphasis on prescription writing during various phases of learning process in medical undergraduates.

Methods: After obtaining institutional ethics committee approval, we recruited 4th to 8th semester medical undergraduate students and interns into the study, who gave written informed consent. They were given a pilot-tested, pre-evaluated questionnaire addressing the issues of prescription writing. They were asked to prescribe for a common clinical scenario. Their prescriptions were analysed for various parameters as indicated in WHO guidelines.

Results: Of the 350 medical undergraduate students and interns invited, 281 of them participated in the study. 169 participants (60.1%) agree that they have not written a formal prescription to any patient when the questionnaire was administered. 134 participants (47.6 %) feel that undergraduate training has not prepared them for prescribing properly. 90% of participants said reinforcing classes during 3rd, 4th year and during Compulsory Routine Rotatory Internship will be beneficial. Though 220 participants have opined that generic name should be used while prescribing, only 124 have actually used generic names in their prescriptions. Fifteen participants have failed to write the symbol while prescribing. All 121 interns in the study have used brand names while prescribing.

Conclusions: There are widespread lacunae in prescription writing by medical undergraduates. There is perceived need for reinforcement sessions at third and final phase of undergraduate education to address this gap. Most participants opine that clinicians do not discuss this issue during case discussion. There is knowledge and practice gap in using generic names while prescribing.

Metrics

Metrics Loading ...

References

Akram A, Mohamad N, Meerah TSM, ZamZam R, Abdullah D. A pilot study-an action research to acquire clinical skill. Procedia Soc Behav Sci. 2012;60:236-40.

Dean B, Schachter M, Vincent C, Barber N. Causes of prescribing errors in hospital inpatients: a prospective study. Lancet Lond Engl. 2002;359(9315):1373-8.

America C. on Q of HC in, Medicine I of To Err Is Human: building a safer health system. National Academies Press; 2000:312.

Al Khaja KAJ, James H, Sequeira RP. Effectiveness of an educational intervention on prescription writing skill of preclerkship medical students in a problem-based learning curriculum. J Clin Pharmacol. 2013;53(5):483-90.

Vollebregt JA, Metz JCM, de Haan M, Richir MC, Hugtenburg JG, de Vries TPGM. Curriculum development in pharmacotherapy: testing the ability of preclinical medical students to learn therapeutic problem solving in a randomized controlled trial. Br J Clin Pharmacol. 2006;61(3):345-51.

Garbutt JM, DeFer TM, Highstein G, McNaughton C, Milligan P, Fraser VF. Safe prescribing: an educational intervention for medical students. Teach Learn Med. 2006;18(3):244-50.

Banerjee I, Bhadury T. Prescribing pattern of interns in a primary health center in India. J Basic Clin Pharm. 2014;5(2):40-3.

Pati R. Prescribing pattern among medical interns at the rural health centres of a medical college, Manipal, Karnataka. Indian J Community Med. 2004;29(3):128.

Bhartiy SS, Shinde M, Nandeshwar S, Tiwari SC. Pattern of prescribing practices in the Madhya Pradesh, India. Kathmandu Univ Med J KUMJ. 2008;6(1):55-9.

Rehan HS, Lal P. Drug prescribing pattern of interns at a government healthcare centre in northern India. Trop Doct. 2002;32(1):4-7.

de Vries TPGM, Henning RH, Hogerzeil HV, Fresle DA. Guide to good prescribing - a practical mannual. Geneva: World Health Organization Action Programme on Essential Drugs; 2012. Available at http://apps.who.int/medicinedocs/pdf/whozip23e/whozip23e.pdf.

Scobie SD, Lawson M, Cavell G, Taylor K, Jackson SHD, Roberts TE. Meeting the challenge of prescribing and administering medicines safely: structured teaching and assessment for final year medical students. Med Educ. 2003;37(5):434-7.

Langford NJ, Martin U, Kendall MJ, Ferner RE. Medical errors. Medical schools can teach safe drug prescribing and administration. BMJ. 2001;322(7299):1424.

Aronson JK, Henderson G, Webb DJ, Rawlins MD. A prescription for better prescribing. BMJ. 2006;333(7566):459-60.

Heaton A, Webb DJ, Maxwell SRJ. Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates. Br J Clin Pharmacol. 2008;66(1):128-34.

Kripalani S, Bussey-Jones J, Katz MG, Genao I. A prescription for cultural competence in medical education. J Gen Intern Med. 2006;21(10):1116-20.

Ross S, Maxwell S. Prescribing and the core curriculum for tomorrow’s doctors: BPS curriculum in clinical pharmacology and prescribing for medical students. Br J Clin Pharmacol. 2012;74(4):644-61.

Kilminster S, Zukas M, Quinton N, Roberts T. Preparedness is not enough: understanding transitions as critically intensive learning periods. Med Educ. 2011;45(10):1006-15.

Tobaiqy M, McLay J, Ross S. Foundation year 1 doctors and clinical pharmacology and therapeutics teaching. A retrospective view in light of experience. Br J Clin Pharmacol. 2007;64(3):363-72.

Coombes ID, Stowasser DA, Coombes JA, Mitchell C. Why do interns make prescribing errors? A qualitative study. Med J Aust. 2008. Available at https://www.mja.com.au/journal/2008/188/2/why-do-interns-make-prescribing-errors-qualitative-study.

Leape LL, Bates DW, Cullen DJ, Cooper J, Demonaco HJ, Gallivan T, et al. Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA. 1995;274(1):35-43.

Midlöv P, Bondesson A, Eriksson T. Effects of educational outreach visits on prescribing of benzodiazepines and antipsychotic drugs to elderly patients in primary health care in southern Sweden. Fam Pr. 2006;23:60-4.

Upadhyaya P, Seth V, Sharma M, Ahmed M, Moghe VV, Khan ZY, et al. Prescribing knowledge in the light of undergraduate clinical pharmacology and therapeutics teaching in India: views of first-year postgraduate students. Adv Med Educ Pr. 2012;3:47-53.

Phalke VD, Phalke DB, Syed MMA, Mishra A, Sikchi S, Kalakoti P. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India. Australas Med J. 2011;4(1):4-8.

Rauniar GP, Roy RK, Das BP, Bhandari G, Bhattacharya SK. Prescription writing skills of pre-clinical medical and dental undergraduate students. JNMA J Nepal Med Assoc. 2008;47(172):197-200.

Akram A, ZamZam R, Mohamad NB, Abdullah D, Meerah SM. An assessment of the prescribing skills of undergraduate dental students in Malaysia. J Dent Educ. 2012;76(11):1527-31.

Jain A, Bhaskar D, Gupta D, Yadav P, Dalai D, Jhingala V, et al. Drug prescription awareness among the 3rd year and final year dental students: a cross-sectional survey. J Indian Assoc Public Heal Dent. 2015;13(1):73.

Hester DO. Do you see what I see? Illegible handwriting can cause patient injuries. J Ky Med Assoc. 2001;99(5):187.

Winslow EH, Nestor VA, Davidoff SK, Thompson PG, Borum JC. Legibility and completeness of physicians’ handwritten medication orders. Heart Lung J Crit Care. 1997;26(2):158-64.

Boehringer PA, Rylander J, Dizon DT, Peterson MW. Improving the quality of the order-writing process for inpatient orders in a teaching hospital. Qual Manag Health Care. 2007;16(3):215-8.

Meyer TA. Improving the quality of the order-writing process for inpatient orders and outpatient prescriptions. Am J Heal-Syst Pharm AJHP Off J Am Soc Heal-Syst Pharm. 2000;57(Suppl 4):S18-22.

Irshaid YM, Al Homrany M, Hamdi AA, Adjepon-Yamoah KK, Mahfouz AA. Compliance with good practice in prescription writing at outpatient clinics in Saudi Arabia. East Mediterr Heal J Rev Santé Méditerranée Orient Al-Majallah Al-Ṣiḥḥīyah Li-Sharq Al-Mutawassiṭ. 2005;11(5-6):922-8.

Pandey AA, Thakre SB, Bhatkule PR. Prescription analysis of pediatric outpatient practice in Nagpur city. Indian J Community Med Off Publ Indian Assoc Prev Soc Med. 2010;35(1):70-3.

Ter Wee RJ, van der Kleijn E, Brenninkmeijer RF, Holmberg N. Development of an electronic prescription processing option: an aid for general practice. Br J Gen Pr J R Coll Gen Pr. 1991;41(345):151-4.

Oshikoya K, Bello J, Ayorinde E. Prescribing knowledge and skills of final year medical students in Nigeria. Indian J Pharmacol. 2008;40(6):251.

Downloads

Published

2017-01-05

How to Cite

Sudha, M. J., Viveka, S., & Remya, S. (2017). Assessment of prescription writing skills among undergraduate medical students. International Journal of Basic & Clinical Pharmacology, 5(4), 1586–1593. https://doi.org/10.18203/2319-2003.ijbcp20162477

Issue

Section

Original Research Articles