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Training aimed at curbing common errors in paediatric prescribing in the UK is inadequate, researchers suggest.
Dr Sharon Conroy of Nottingham University Medical School, and colleagues say their findings area based on a trawl of published research on techniques for cutting prescribing errors and on a survey of healthcare professionals and medicines researchers.
In the study, just published ahead of print in Archives of Disease in Childhood, the researchers say children pose particular prescribing problems because the lack of formulations designed specifically for them means doses must be individually calculated, increasing the chances of error.
Children are also particularly vulnerable to the consequences of a mistake.
Previous research shows that junior doctors often feel unable to prescribe confidently, or do not know which drugs to prescribe for conditions such as chest infections or anaphylaxis.
The authors could find only two relevant published studies on teaching of prescribing skills or ways to assess competencies.
These showed that the error rate fell after particular techniques were introduced, but it was impossible to tell from the conclusions which had proved most effective.
In total, 319 out of 559 survey questionnaires were returned – a 57% response rate.
The responses showed that in the UK training in paediatric prescribing error was brief and mainly in lecture format, with little hands-on training.
Eleven centres taught drug-chart completion, seven discussed common prescribing errors, and one provided a computer-based course on correct calculation of drug doses.
But in 13 centres training took the form of a 30–60-minute presentation by specialist pharmacists, mostly at induction, and 10 centres gave trainees an induction pack containing written information.
Only three centres tested prescribing competency, using workbooks, questions during lectures or formal testing.
The authors acknowledge that their research may not provide a comprehensive picture of prescribing training, but there is currently no validated assessment method nor any national standards on teaching of paediatric prescribing, they say.
They suggest that at the very least it is important to find out which teaching methods work best to cut errors, if indeed any are effective.
Online First Arch Dis Child 2007
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