Poor Drugs Training ‘is Killing Patients’
Patients are dying because young doctors no longer receive adequate training in prescribing drugs, leading pharmacologists said yesterday. Four eminent specialists said knowledge of how to use drugs was alarmingly low among medical students and junior doctors at a time when increasingly complicated medications were being taken by more people. Speaking at a meeting to mark the 75th anniversary of the British Pharmacological Society in London, they said that many clinical pharmacology departments had closed and blamed Government performance targets for marginalising the subject.
Research suggests that about one in 16 hospital admissions is caused by adverse reactions to drugs, most of which are avoid-able. One recent study put the cost of the problem to the National Health Service at £466 million.
Prof Sir Michael Rawlins, the chairman of the Government’s medicines watchdog the National Institute for Health and Clinical Excellence (Nice) blamed the General Medical Council, which is responsible for undergraduate medical education, for falling levels of knowledge.
Prof Rawlins, who is a professor of clinical pharmacology at Newcastle University, said: “There has been a decline in the teaching of pharmacology and that has an effect on basic drug safety. The competence of young doctors in prescribing is a very serious problem. Frankly, the GMC have not made sure that young doctors are taught to prescribe safely.”
In 2003 there were 68 specialists practising clinical pharmacology and therapeutics (CPT) in Britain. While the total number of medical specialists increased by 79 per cent between 1993 and 2003, in CPT it dropped 24 per cent. About half of those current specialists are expected to retire over the next decade.
Prof David Webb, the chairman of the Scottish Medicines Consortium and a professor of therapeutics and clinical pharmacology at the University of Edinburgh, said medical students were privately expressing concerns at their own lack of prescribing knowledge.
He said: “Patients are becoming ill and some are dying as a result of poor prescribing. There is no doubt about that. A substantial proportion of that is undoubtedly avoidable. Our medical schools could be training much better and safer doctors.
“The increasing focus on performance targets within the health service has marginalised specialities such as CPT where performance is difficult to measure. Distinct courses and assessments in CPT, formerly a staple in the curriculum, are disappearing.”
A study published two years ago found that at two hospitals on Merseyside, 1,225 patients aged 17 or over out of 18,820 were admitted as a result of adverse drug reactions. Other research has suggested that between five and 10 per cent of all hospital inpatients experience an adverse drug reaction during their stay.
A spokesman for the GMC said: “We refute the suggestion that medical undergraduates are failing to learn to prescribe properly. It is clearly stated in our guidance that medical students must be taught to prescribe safely and effectively.”