Doctors learn new tricks, but do they remember them? Lack of effect of an educational intervention in improving <scp>O</scp>xygen prescribing

Myers, Hamish; Taylor, Julia; Finn, Rhian S.; Beckert, Lutz

doi:10.1111/resp.12614

Cited by 7 publications

(7 citation statements)

References 10 publications

(10 reference statements)

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“…In a timely reminder that, in the real world, such guidelines are only as good as their effective implementation, Myers et al . showed that, despite an educational programme, doctors fail to sustain the basic step of prescribing oxygen therapy in over 70% of cases . Single interventions, such as physician education, may not be effective in influencing complex behaviours typically required in clinical medicine.…”

Section: Copdmentioning

confidence: 99%

“…96 In a timely reminder that, in the real world, such guidelines are only as good as their effective implementation, Myers et al showed that, despite an educational programme, doctors fail to sustain the basic step of prescribing oxygen therapy in over 70% of cases. 97 Single interventions, such as physician education, may not be effective in influencing complex behaviours typically required in clinical medicine. Similarly, Berkhof et al, in a randomized study, found that regular telemedicine consultations alone without educational or other complementary interventions in COPD patients resulted in lower quality of life scores and greater healthcare utilization.…”

Section: Non-pharmacological Therapymentioning

confidence: 99%

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Year in review 2015: Asthma and chronic obstructive pulmonary disease

et al. 2016

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Asthma continues to cause substantial morbidity and mortality, affecting some 300 million people worldwide, with a large proportion of those poorly controlled.1-3 In the last year, Respirology published a broad-based range of papers focusing on this important disease, ranging from questionnaire studies to molecular biology in mouse models. 4,5 This range of papers emphasizes the breadth of asthma research underway and the role of Respirology in disseminating these advances.

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Section: Copdmentioning

confidence: 99%

Section: Non-pharmacological Therapymentioning

confidence: 99%

Year in review 2015: Asthma and chronic obstructive pulmonary disease

et al. 2016

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“…Myers and colleagues (2015) investigated whether doctors remembered new learning in the long-term. They found that doctors’ prescriptions relating to oxygen improved significantly immediately after an educational intervention, but that this improvement was not sustained at a 4-year follow-up [41]. Jayaweera and colleagues (2018) reviewed various assessments to determine whether each contributed something unique to general medical practitioner ‘Tests of Competence’ and ascertain if information could be gleaned about FtP (since these tests are conducted on those referred for FtP issues).…”

Section: Discussionmentioning

confidence: 99%

Topic Analysis of UK Fitness to Practise Cases: What Lessons Can Be Learnt?

Hanna

2019

Pharmacy

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Background: Fitness to practise (FtP) impairment (failure of a healthcare professional to demonstrate skills, knowledge, character and/or health required for their job) can compromise patient safety, the profession’s reputation, and an individual’s career. In the United Kingdom (UK), various healthcare professionals’ FtP cases (documents about the panel hearing(s) and outcome(s) relating to the alleged FtP impairment) are publicly available, yet reviewing these to learn lessons may be time-consuming given the number of cases across the professions and amount of text in each. We aimed to demonstrate how machine learning facilitated the examination of such cases (at uni- and multi-professional level), involving UK dental, medical, nursing and pharmacy professionals. Methods: Cases dating from August 2017 to June 2019 were downloaded (577 dental, 481 medical, 2199 nursing and 63 pharmacy) and converted to text files. A topic analysis method (non-negative matrix factorization; machine learning) was employed for data analysis. Results: Identified topics were criminal offences; dishonesty (fraud and theft); drug possession/supply; English language; indemnity insurance; patient care (including incompetence) and personal behavior (aggression, sexual conduct and substance misuse). The most frequently identified topic for dental, medical and nursing professions was patient care whereas for pharmacy, it was criminal offences. Conclusions: While commonalities exist, each has different priorities which professional and educational organizations should strive to address.

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“…Previous studies have implemented interventions to combat poor prescribing practice, mandatory educational sessions [34,35,36], pharmacist reviews [37], and prompting prescribers to prescribe oxygen on charts [34], which have shown positive improvements in line with guideline recommendations. Given that audits are cyclical, we recommend implementation of these interventions and a re-audit.…”

Section: Other Audit Comparisons and Recommendationsmentioning

confidence: 99%

Acute oxygen therapy: a cross-sectional study of prescribing practices at an English hospital immediately before COVID-19 pandemic

Barrett

Catangui

Scott

2020

Expert Review of Respiratory Medicine

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Background: Approximately 14% of UK hospital in-patients receive supplemental oxygen therapy, only 57% have valid prescriptions. Oxygen must be optimally prescribed to ensure maximal therapeutic response whilst minimizing adverse outcomes (including fatality). This study investigates prescription compliance. Methods: All adults admitted to medical wards (18 February to 3 March 2020) were included. Analyses present proportions, descriptive statistics, and hypothesis testing. Ethical approval was unnecessary for this audit. Results: Of the 636 patients admitted, 66 (10%) were receiving oxygen therapy. Ages ranged from 34 to 100 years with 36 (54.5%) males and 30 (45.5%) females. The prescription was not documented in the oxygen section of the drug chart (n = 37, 56.1%, p = 0.389), nor did it have the physicians signature (n = 40, 60.6%, p = 0.110) nor date (n = 46, 69.7%, p = 0.002). Thirteen chronic obstructive pulmonary disease (COPD) patients (19.7%) were at risk of hypercapnic failure (p = 1.582x10 −6). Target oxygen saturation (SpO2) range had been documented for 30 (45.5%) patients. A target SpO2 range of 88-92% was documented for 9 patients (13.6%), a 94-98% range documented for 11 patients (16.7%). All patients had an invalid prescription. Conclusion: We present real-world practice in naturalistic settings, immediately before pandemiclockdown. Enhanced compliance is advocated to reduce risks of harm and mortality.

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Doctors learn new tricks, but do they remember them? Lack of effect of an educational intervention in improving Oxygen prescribing

Cited by 7 publications

References 10 publications

Year in review 2015: Asthma and chronic obstructive pulmonary disease

Year in review 2015: Asthma and chronic obstructive pulmonary disease

Topic Analysis of UK Fitness to Practise Cases: What Lessons Can Be Learnt?

Acute oxygen therapy: a cross-sectional study of prescribing practices at an English hospital immediately before COVID-19 pandemic

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