2 Prescribing challenges in modern practice. (1st December 2018)

• Record Type: Journal Article
• Authors: Coleman, Jamie J
• Is Part Of: Postgraduate medical journal. Volume 94(2018)Supplement 1
• Page Start: A1
• Page End: A2
• Publication Date: 2018-12-01
• Subjects: Medicine -- Periodicals; 610
• DOI: 10.1136/postgradmedj-2018-fpm.2
• Languages: English
• ISSNs: 0032-5473

Abstract

Abstract: : Prescribing is the most common patient-level intervention within healthcare. The growth in number of licensed medicinal products over the last century through an 'age of excitement' in clinical pharmacological and pharmaceutical research means that prescribing is an increasingly complex task. The complexity is increased further by increasing multimorbidity in an ageing population, which can lead to potentially inappropriate polypharmacy. Providing medication without harm is a challenge to modern society and the World Health Organisation has set a challenge to reduce medication-related harm by 50% globally by 2022. 1 A key aim in the UK is to provide support to all prescribers to reduce prescribing errors through a variety of interventions including education and training, interprofessional communication and support, and digital technologies (incorporating clinical decision support). Comprehensive therapeutic care involves the assessment of the utilization, quality, clinical appropriateness and ongoing cost of prescribed medications. An important skill of the modern prescriber is knowing when not to prescribe or indeed withdrawing inappropriate medication under supervision, with the goal of managing inappropriate polypharmacy and improving outcomes: the process of 'Deprescribing'. 2 Modern practice requires prescribers to be able to provide holistic therapeutic care in a patient-centred approach. This can be challenging when patients are receiving care from a variety of specialists. The prescribing itself may be devolved to other colleagues (junior doctors or family practitioners) from the original decision maker. Communication and collaboration between healthcare practitioners and patients is essential if important pharmaceutical care guidance is followed according to best practice. References: World Health Organisation. Medication without harm: WHO's third global patient safety challenge 2017. Available at: http://www.who.int/patientsafety/medication-safety/en/ (Accessed: 20/05/2018). Reeve E, Thompson W, Farrell B. Deprescribing: A narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur J Intern Med 2017 March;38:3–11.