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Guidelines For More Conservative Prescribing Practices

Ruzanna Harutyunyan's picture

Information on drugs and treatment for specific diseases is abundant in medical education, but a need for guiding principles for ways to effectively prescribe is drawing attention. In a Commentary published in the February 25 issue of the Journal of the American Medical Association, a physician from Brigham and Women’s Hospital (BWH) and his colleague suggest 25 principles to help prescribers improve their effectiveness.

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Recent reports from the Association of American Medical Colleges (AAMC) expressed major concern with the current state of pharmacology teaching, specifically, the influence that the pharmaceutical industry has at all stages of medical education. “While addressing these concerns, we also need to think about providing prescribers with a set of comprehensive guiding principles,” said Gordon Schiff, MD, of the Department of Medicine at BWH. “Educational reform alone is not sufficient to ensure the most efficient and successful prescribing practice.”

The Commentary suggests 25 principles to help trainees become more careful, cautious, evidence-based prescribers. The guidelines cover a range of focuses, including strengthening the patient-prescriber relationship, practicing caution and skepticism when prescribing drugs that are new to the market, considering therapeutic options other than drugs when appropriate, and reducing adverse drug events.

“Taken separately, none of the principles are novel, but when combined, they represent a significant shift in current prescribing patterns,” said Dr. Schiff. The authors address the two dueling philosophies of pharmacology by finding a balance between the current thinking pattern that newer and more is better, and the previous idea that fewer and more time-tested drugs are best.