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This study examines the impact of the WHO Guide to Good Prescribing on medical students' reasoning and problem-solving capabilities in pharmacotherapy. The study, conducted over a 3-year period, aims to improve students' prescribing skills and foster a multidisciplinary approach to healthcare. The results show significant improvement in students' performance.
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Impact of WHO Guide to Good Prescribing on Medical Students Abdelkader Helali*, Nadjat Loumi* *: Centre National de Pharmacovigilance et de Matériovigilance. Algiers (Algeria) ICIUM 2011, Antalya Nov 14th – 18th 2011
Objectives: To measure the impact of the WHO Guide of Good Prescribing a model with 6 steps to improve students’ reasoning and solving capabilities in pharmacotherapy with a study over a 3 years (to insure data reproducibility); To discuss the inter- relationship between pharmacotherapy and other disciplines for more openness and pro-active approach in finding allies and forming multidisciplinary coalitions. Study population:Students at the 6th year undergraduate Algiers’ Faculty of Medicine (Algeria). Intervention:198 Students, randomly selected on voluntary basis, divided into 2 groups: a control group with 65 students and study group with 133 students. Training:Students were invited to prescribe to relief symptomatic pain (migraine, acute hepatic colic, acute renal colic, arthritis, irritable bowel syndrome, acute pharyngitis) Tests:3 open problems (A, B, C) and 3 structured problems (X, Y, Z) was successively presented. Scoring of tests:1= no answer, 2= poor answer, 3= arguable answer, 4= acceptable answer, 5= good answer ICIUM 2011, Antalya Nov 14th – 18th 2011
Design of the study1 1: Adapted from TPGM de Vries, RH Henning, JS Bapna, HV Hogerzeil & al. Lancet 1995; 346: 1454-57 ICIUM 2011, Antalya Nov 14th – 18th 2011
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y1 y1 y2 y2 y3 y3 y1 y2 y3 * * * * * * * * * * * * * * * * * Problems X,Y,Z Problem A Problems B, C T2: Test 4 weeks later (remembering of method) T0: Prestudy test Control Group Control Group Study Group Study Group T1: Test immediately after the training period of 8 weeks * P < 0.05 Control Group Y: Years of the study Study Group ICIUM 2011, Antalya Nov 14th – 18th 2011
y1 y1 y2 y2 y3 y3 y1 y3 y2 * * * * * * * * * * * * * * * * * * Problems X,Y,Z Problem A Problems B, C T2: Test 4 weeks later (remembering of method) T0: Prestudy test Control Group Control Group Study Group Study Group T1: Test immediately after the training period of 8 weeks * P < 0.05 Control Group Y: Years of the study Study Group ICIUM 2011, Antalya Nov 14th – 18th 2011
y1 y1 y2 y2 y3 y3 * * * y1 y3 y2 * * * * * * * * * * * * * * * Problems X,Y,Z Problem A Problems B, C T2: Test 4 weeks later (remembering of method) T0: Prestudy test Control Group Control Group Study Group Study Group T1: Test immediately after the training period of 8 weeks * P < 0.05 Control Group Y: Years of the study Study Group ICIUM 2011, Antalya Nov 14th – 18th 2011
Policy implication • Foster a critical thinking, self-directed learning and use of multidisciplinary inputs to bridge the gap between fundamental sciences, clinical practice, critical analysis, social and behavioural sciences for more rational prescribing and uses ; • Prepare the students to become a part of the healthcare system and develop their skills. Prepare them to Investigate Drug Use in their health facilities by using selected drug use indicators for identifying their needs and planning for continuous training and better use of medicines ; • Make students ready to understand community needs for safe practice and provide with Epidemiology, Method for Selecting Essential Medicines List at their health facilities or at country level, developing a Personal Formulary to become more competent in prescribing. Future study and Research • Comparative multicentre studies of cost-effectiveness of teaching WHO Guide of Good Prescribing as short term pharmacotherapy training in different setting in undergraduate medical education in low and middle income countries. • Foster Multidisciplinary looking at prescribing practice at real life scenarios (not only at simulated cases). • Promote drawing up a Model Core Curriculum for undergraduate medical students using WHO Good Prescribing on the basis of WHO Model Essential Medicines List adjusted to the country needs. ICIUM 2011, Antalya Nov 14th – 18th 2011