WHO guide to good prescribing is 25 years old: quo vadis?

Abstract

Introduction Twenty-five years ago, the World Health Organization (WHO) published the Guide to Good Prescribing (GGP), followed by the accompanying Teacher's Guide to Good Prescribing (TGGP). The GGP is based on a normative 6-step model for therapeutic reasoning and prescribing, and provides a six-step guide for students to the process of rational prescribing. Method We reviewed the need to update both WHO publications by evaluating their use and impact, including new (theoretical) insights and demands. Based on information from literature, Internet, and other (personal) sources, we draw the following conclusions. Results 1. An update of the GGP and TGGP, both in terms of content and form, is necessary because of the current need for these tools (irrational medicine use and unavailability of medicines), the lack of similar documents, and the lack of connection with recent developments, such as Internet and modern education; 2. The basic (6-step) model of the GGP is effective in terms of rational prescribing in the undergraduate situation and is still consistent with current theories about (context) learning, clinical decision-making, and clinical practice; 3. The dissemination and introduction of the GGP and TGGP in education has been successful so far, but is still not optimal because of lack of support and cooperation. Conclusions On the basis of the evaluation results, a plan for the revision of the GGP and TGGP is presented.

La receta médica: ¿reflejo condicionado o reflexión consciente?

“…Los malos hábitos de prescripción son origen de tratamientos inefectivos e inseguros que pueden exacerbar o alargar la enfermedad, producir tensión y daño al paciente y costos más altos, como advierte la Organización Mundial de la Salud (OMS). 1 Al analizar la capacidad prescriptiva de médicos jóvenes recién egresados que fueron evaluados en pregrado y seis meses después de su graduación, se observó que la mitad seleccionó el medicamento inadecuado o dudoso, un tercio no escribió correctamente la receta y dos tercios no pudieron sustentar académicamente el medicamento prescrito. Algunos médicos señalaban que sus hábitos de prescripción mejorarían después al terminar sus estudios de pregrado, sin embargo, la investigación demostró que las aptitudes prescriptivas no tuvieron grandes avances después de la graduación a pesar de adquirir experiencia en general.…”

Pharmacist-Led Education for Final Year Medical Students: A Pilot Study

“…The GGP is a 6-step model for rational prescribing aimed at undergraduate medical students and their teachers. Many places around the world have based their medical student or graduate learning and teaching on this model, including; the Netherlands, Canada, Spain, and Turkey ( 9 ). The National Prescribing Service (NPS) in Australia online modules on prescribing standards were developed based on the GGP.…”

“…The relative and potentially significant role of subsequent experiential learning is neither captured nor clarified. The UK have developed a compulsory online national Prescribing Safety Assessment (PSA) for final-year medical students based on a similar framework (10-step) ( 9 ). The differences in the delivery of medical education within and between European countries could impact students results on the PSA, thus supporting EACPT suggestion to create a uniform core curriculum for European medical schools ( 7 ).…”

European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

“…This will complement the wish of the European Association for Clinical Pharmacology and Therapeutics (EACPT) to harmonise European training in CP&T 13 and will be included in a future revision of the Guide to Good Prescribing of the WHO. 14 Previous studies of such lists have been based on the opinions of individuals or small groups of experts or were specific to one country. [15][16][17][18] Therefore, the aim of this study is to reach consensus on a list of medicines that are widely prescribed and available in Europe and which European junior doctors should be able to independently prescribe safely and effectively without direct supervision, that is, the European List of Essential Medicines for Medical Education.…”