ABSTRACT
Objectives: The aims of this study were to evaluate: [1] the prevalence and types of potentially inappropriate prescribing in older adults with hypertension or diabetes mellitus and hypertension, and [2] whether or not differences in the training of primary care physicians were associated with potentially inappropriate prescribing
Materials and Methods: Primary care prescriptions issued by family physicians and general practitioners were audited using Screening Tool of Older Persons' Prescriptions criteria [version 1], with 18 out of 65 applicable criteria. Descriptive statistics were used to test the difference between proportions, and two-tailed t test was used for continuous variables
Results: A total of 2,090 outpatient prescriptions were written during the study period; of these, 712 [34.1%] were potentially inappropriate. The mean number of drugs per patient was 6.03 [+/-2.5]. Of the 712 prescriptions, 543 [76.3%] were used for the treatment of acute medical illnesses. The most common examples of potentially inappropriate prescribing were: orphenadrine [n = 174; 8.33%], long-term nonsteroidal anti-inflammatory drugs for > 3 months [n = 150; 7.18%], proton pump inhibitors for > 8 weeks [n = 135; 6.46%], antihypertensive therapy duplication [n = 59; 2.82%], long-acting glyburide [n = 48; 2.29%], and chlordiazepoxide for > 1 month [n = 44; 2.11%]. Family physicians showed a greater tendency toward potentially inappropriate prescribing compared to general practitioners, but the difference was nonsignificant [n = 514 [34.75%] vs. n = 162 [31.3%]; p = 0.16]
Conclusions: The prevalence of potentially inappropriate prescribing [i.e., 34.1%] was within the spectrum reported worldwide and unrelated to the training backgrounds of physicians. Most of the identified potentially inappropriate prescribing [76.3%] in older adults was associated with medications for acute medical illnesses and hence inappropriate polypharmacy should be discouraged
ABSTRACT
Objectives: This study aimed to explore reasons for poor performance in prescription writing stations of the objective structured practical examination [OSPE] and absenteeism in prescription writing sessions among preclerkship medical students at the Arabian Gulf University [AGU] in Manama, Bahrain
Methods: This descriptive study was carried out between September 2014 and June 2015 among 157 preclerkship medical students at AGU. Data were collected using focus group discussions and a questionnaire with closed- and open-ended items
Results: All 157 students participated in the study [response rate: 100.0%]. The most frequently cited reasons for poor performance in OSPE stations were an inability to select the correct drugs [79.6%], treatment duration [69.4%], drug quantity [69.4%] and drug formulation [68.2%]. Additionally, students reported inadequate time for completing the stations [68.8%]. During focus group discussions, students reported other reasons for poor performance, including examination stress and the difficulty of the stations. Absenteeism was attributed to the length of each session [55.4%], lack of interest [50.3%], reliance on peers for information [48.4%] and optional attendance policies [47.1%]. Repetitive material, large group sessions, unmet student expectations and the proximity of the sessions to summative examinations were also indicated to contribute to absenteeism according to open-ended responses or focus group discussions
Conclusion: This study suggests that AGU medical students perform poorly in prescription writing OSPE stations because of inadequate clinical pharmacology knowledge. Participation in prescription writing sessions needs to be enhanced by addressing the concerns identified in this study. Strategies to improve attendance and performance should take into account the learner-teacher relationship