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Marquet P, Jouanjus E, Sáez-Peñataro J, Sancho-Lopez A. Activities of clinical pharmacologists across Europe: A survey by the European association of clinical pharmacology and therapeutics. Eur J Clin Pharmacol 2024:10.1007/s00228-024-03657-x. [PMID: 38466425 DOI: 10.1007/s00228-024-03657-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE In order to explore clinical pharmacology and therapeutics (CPT) teaching and practices across continental Europe, the European Association of Clinical Pharmacology and Therapeutics (EACPT) made a survey in 2022 amongst its 27 affiliated societies. METHODS The survey was made available online to EACPT representatives, and 47 filled-in questionnaires were received from 25 countries (one to five per country), representing all geographic areas of Europe. RESULTS Clinical pharmacologists (CPs) spend 25%, 30%, 15%, and 25% of their time in teaching, hospital activities, committees, and research, respectively, with large variations across and within countries. CPT courses are given at Schools of Medicine in all the countries except one, mostly organized and taught by medical doctors (MDs). In Central, Western, and Southern Europe, the teachers may have medicine or pharmacy training. Therapeutic drug monitoring and pharmacovigilance were the hospital activities most frequently reported, and clinical/forensic toxicology, rounds of visits, and pharmacogenetics the least. Two-thirds of the panel think CPs should be MDs. However, the transversal nature of CPT was underlined, with patients/diseases and drugs as gravity centres, thus calling for the complementary skills of MDs and PharmDs. Besides, most respondents reported that clinical pharmacists in their country are involved in rounds of visits, pharmacovigilance, TDM, and/or pharmacogenetic testing and that collaborations with them would be beneficial. CONCLUSION CPT comes with a plurality of backgrounds and activities, all required to embrace the different pathologies and the whole lifecycle of medicinal products, but all of them being rarely performed in any given country. The willingness to use common CPT teaching material and prescribing exams at the European level is a good sign of increasing harmonisation of our discipline Europewide.
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Affiliation(s)
- Pierre Marquet
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, CBRS, 2 rue Bernard Descottes, 87000, Limoges, France.
- Pharmacology & Transplantation, UMR1248 Inserm, Université de Limoges, CHU de Limoges, Limoges, France.
| | - Emilie Jouanjus
- Addictovigilance Centre, Department of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France
- CERPOP, University of Toulouse, Inserm, Toulouse, France
| | - Joaquin Sáez-Peñataro
- Department of Clinical Pharmacology, Area Medicament, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Aranzazu Sancho-Lopez
- Department of Clinical Pharmacology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
- IDIPHISA-Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, Madrid, Spain
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Donker EM, Spitaleri Timpone P, Brinkman DJ, Richir MC, Papaioannidou P, Likic R, Sanz EJ, Christiaens T, Costa JN, De Ponti F, Gatti M, Böttiger Y, Kramers C, Pandit R, van Agtmael MA, Tichelaar J. The European List of Key Medicines for Medical Education: A Modified Delphi Study. Clin Pharmacol Ther 2024; 115:515-524. [PMID: 38062784 DOI: 10.1002/cpt.3132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023]
Abstract
Rational prescribing is essential for the quality of health care. However, many final-year medical students and junior doctors lack prescribing competence to perform this task. The availability of a list of medicines that a junior doctor working in Europe should be able to independently prescribe safely and effectively without supervision could support and harmonize teaching and training in clinical pharmacology and therapeutics (CPT) in Europe. Therefore, our aim was to achieve consensus on such a list of medicines that are widely accessible in Europe. For this, we used a modified Delphi study method consisting of three parts. In part one, we created an initial list based on a literature search. In part two, a group of 64 coordinators in CPT education, selected via the Network of Teachers in Pharmacotherapy of the European Association for Clinical Pharmacology and Therapeutics, evaluated the accessibility of each medicine in his or her country, and provided a diverse group of experts willing to participate in the Delphi part. In part three, 463 experts from 24 European countries were invited to participate in a 2-round Delphi study. In total, 187 experts (40%) from 24 countries completed both rounds and evaluated 416 medicines, 98 of which were included in the final list. The top three Anatomical Therapeutic Chemical code groups were (1) cardiovascular system (n = 23), (2) anti-infective (n = 21), and (3) musculoskeletal system (n = 11). This European List of Key Medicines for Medical Education could be a starting point for country-specific lists and could be used for the training and assessment of CPT.
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Affiliation(s)
- Erik M Donker
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Pietro Spitaleri Timpone
- Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - David J Brinkman
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Milan C Richir
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paraskevi Papaioannidou
- Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Robert Likic
- Unit of Clinical Pharmacology, Department of Internal Medicine, University Hospital Centre Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
| | - Emilio J Sanz
- School of Health Science, Universidad de La Laguna, and Hospital Universitario de Canarias (SCS), Santa Cruz de Tenerife, Spain
| | - Thierry Christiaens
- Unit of Clinical Pharmacology, Department of Fundamental and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - João N Costa
- Laboratory of Clinical Pharmacology and Therapeutics, University of Lisbon, Lisbon, Portugal
- Instituto de Medicina Molecular, Lisbon, Portugal
| | - Fabrizio De Ponti
- Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Milo Gatti
- Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Ylva Böttiger
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Cornelis Kramers
- Department of Clinical Pharmacy, CWZ, Nijmegen, The Netherlands
- Department of Internal Medicine, Radboud University, Nijmegen, The Netherlands
| | - Rahul Pandit
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michiel A van Agtmael
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Jelle Tichelaar
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
- Interprofessional Collaboration and Medication Safety at the Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands
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Donker EM, Osmani H, Brinkman DJ, van Rosse F, Janssen B, Knol W, Dumont G, Jorens PG, Dupont A, Christiaens T, van Smeden J, de Waard-Siebinga I, Peeters LEJ, Goorden R, Hessel M, Lissenberg-Witte BI, Richir MC, van Agtmael MA, Kramers C, Tichelaar J. The impact of a summative national prescribing assessment and curriculum type on the development of the prescribing competence of junior doctors. Eur J Clin Pharmacol 2023; 79:1613-1621. [PMID: 37737911 PMCID: PMC10663181 DOI: 10.1007/s00228-023-03567-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE The primary aim of this study was to investigate the effect of including the Dutch National Pharmacotherapy Assessment (DNPA) in the medical curriculum on the level and development of prescribing knowledge and skills of junior doctors. The secondary aim was to evaluate the relationship between the curriculum type and the prescribing competence of junior doctors. METHODS We re-analysed the data of a longitudinal study conducted in 2016 involving recently graduated junior doctors from 11 medical schools across the Netherlands and Belgium. Participants completed three assessments during the first year after graduation (around graduation (+ / - 4 weeks), and 6 months, and 1 year after graduation), each of which contained 35 multiple choice questions (MCQs) assessing knowledge and three clinical case scenarios assessing skills. Only one medical school used the DNPA in its medical curriculum; the other medical schools used conventional means to assess prescribing knowledge and skills. Five medical schools were classified as providing solely theoretical clinical pharmacology and therapeutics (CPT) education; the others provided both theoretical and practical CPT education (mixed curriculum). RESULTS Of the 1584 invited junior doctors, 556 (35.1%) participated, 326 (58.6%) completed the MCQs and 325 (58.5%) the clinical case scenarios in all three assessments. Junior doctors whose medical curriculum included the DNPA had higher knowledge scores than other junior doctors (76.7% [SD 12.5] vs. 67.8% [SD 12.6], 81.8% [SD 11.1] vs. 76.1% [SD 11.1], 77.0% [12.1] vs. 70.6% [SD 14.0], p < 0.05 for all three assessments, respectively). There was no difference in skills scores at the moment of graduation (p = 0.110), but after 6 and 12 months junior doctors whose medical curriculum included the DNPA had higher skills scores (both p < 0.001). Junior doctors educated with a mixed curriculum had significantly higher scores for both knowledge and skills than did junior doctors educated with a theoretical curriculum (p < 0.05 in all assessments). CONCLUSION Our findings suggest that the inclusion of the knowledge focused DNPA in the medical curriculum improves the prescribing knowledge, but not the skills, of junior doctors at the moment of graduation. However, after 6 and 12 months, both the knowledge and skills were higher in the junior doctors whose medical curriculum included the DNPA. A curriculum that provides both theoretical and practical education seems to improve both prescribing knowledge and skills relative to a solely theoretical curriculum.
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Affiliation(s)
- Erik M Donker
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.
| | - Hayaudin Osmani
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - David J Brinkman
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Floor van Rosse
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ben Janssen
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands
| | - Wilma Knol
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Glenn Dumont
- Department of Hospital Pharmacy and Clinical Pharmacology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Philippe G Jorens
- Department Pharmacotherapy, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Alain Dupont
- Department of Clinical Pharmacology, Free University of Brussels (VUB), Brussels, Belgium
| | - Thierry Christiaens
- Clinical Pharmacology, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Jeroen van Smeden
- Department of Education, Centre for Human Drug Research, Leiden, The Netherlands
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Itte de Waard-Siebinga
- Department Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Laura E J Peeters
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ronald Goorden
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marleen Hessel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Milan C Richir
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michiel A van Agtmael
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Cornelis Kramers
- Pharmacology-Toxicology and Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jelle Tichelaar
- Unit Pharmacotherapy, Department of Internal Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Research and Expertise Centre in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
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Belančić A, Sans-Pola C, Jouanjus E, Alcubilla P, Arellano AL, Žunić M, Nogueiras-Álvarez R, Roncato R, Sáez-Peñataro J. European association for clinical pharmacology and therapeutics young clinical pharmacologists working group: a cornerstone for the brighter future of clinical pharmacology. Eur J Clin Pharmacol 2022; 78:691-694. [PMID: 35037981 PMCID: PMC8761867 DOI: 10.1007/s00228-022-03277-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022]
Abstract
The European Association for Clinical Pharmacology and Therapeutics (EACPT) is a leading society in Europe serving the European and global Clinical Pharmacology and Therapeutics community. Its specific aims include promotion of the utilisation and divulgation of the utility of clinical pharmacology services in health care delivery. EACPT currently has four active working groups (WGs): Education, Regulatory affairs, Clinical research and Young Clinical Pharmacologists (YCP WG). EACPT YCP WG was established in 2015 with the idea of improving education, research, training and networking/mobility opportunities for YCPs across Europe and globe. The main objective of the present manuscript is to provide detailed information on general characteristics, structure, chronogram, objectives, accomplishments and current/future focus areas of the EACPT YCP WG. Consequently, we tend to notably enhance EACPT YCP WG's visibility, increase the number of its members and mobility/networking options and to expand areas of activity even more. Moreover, by this we can also make clinical pharmacology more attractive to early career fellows and colleagues and empower its position alongside other medical specialties.
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Affiliation(s)
- Andrej Belančić
- Department of Clinical Pharmacology, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000, Rijeka, Croatia.
| | - Carla Sans-Pola
- Department of Clinical Pharmacology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Emilie Jouanjus
- Addictovigilance Center, Department of Medical Pharmacology, Toulouse University Hospital, Toulouse, France
| | - Pau Alcubilla
- Department of Clinical Pharmacology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ana Lucía Arellano
- Department of Clinical Pharmacology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Miodrag Žunić
- Department of Anesthesiology, Intensive Care and Pain Management, University Medical Center Maribor, Maribor, Slovenia
| | - Rita Nogueiras-Álvarez
- Department of Clinical Pharmacology, Badajoz University Hospital, Badajoz, Extremadura, Spain
| | - Rossana Roncato
- Experimental and Clinical Pharmacology Unit, Centro Di Riferimento Oncologico Di Aviano (CRO) IRCCS, Aviano, Italy.,Italian Society of Pharmacology (SIF), Milan, Italy
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Mokrzecki S, Pain T, Mallett A, Perks S. Pharmacist-Led Education for Final Year Medical Students: A Pilot Study. Front Med (Lausanne) 2021; 8:732054. [PMID: 34631750 PMCID: PMC8496736 DOI: 10.3389/fmed.2021.732054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Prescribing is a core skillset for medical officers. Prescribing errors or deficiencies can lead to patient harm and increased healthcare costs. There is an undefined role for pharmacist-led education to final year medical students to improve prescribing skills. Aim: Assess if pharmacist-led education on prescription writing improves the quality and safety of final year medical students' prescribing skills. Method: Participants and Intervention: Final year medical students were randomised into tutorial (TG) or non-tutorial groups (NTG) and assessed pre- and post- intervention. TG received education by a clinical pharmacist and pharmacy educator using case-based learning. NTG received no additional training as per usual practice. Following the pre-test, all students completed a 3-week tertiary hospital medical ward placement. Students completed the post-test following placement and after the TG participated in the intervention. Student Assessment: Assessment included writing Schedule 4 (S4, prescription only), Schedule 8 (S8, controlled drug), S4 streamline (S4SL), and Mixed case (S4 and S8) prescriptions. Results: At baseline, there were no significant differences between TG and NTG for overall scores or proportion of passes. Post intervention scores significantly improved in TG (p = 0.012) whereas scores significantly decreased in the NTG (p = 0.004). The overall proportion of passes was significantly higher in the TG than NTG (p < 0.001). Conclusion: Education by a clinical pharmacist improved short-term prescribing skills of final year medical students in this study. Students learning primarily experientially from peers and rotational supervisors showed decreased prescribing skills. We propose pharmacist-led education on prescription writing should be further evaluated in larger studies across more student cohorts and for longer periods of follow up time to clarify whether such an educational model could be included in future medical school curricula.
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Affiliation(s)
- Sophie Mokrzecki
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Pharmacy Department, Townsville University Hospital, Townsville, QLD, Australia
| | - Tilley Pain
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Allied Health Department, Townsville University Hospital, Townsville, QLD, Australia
| | - Andrew Mallett
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.,Institute of Health Research and Innovation, Townsville University Hospital, Townsville, QLD, Australia
| | - Stephen Perks
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Pharmacy Department, Townsville University Hospital, Townsville, QLD, Australia
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The scientific basis of rational prescribing. A guide to precision clinical pharmacology based on the WHO 6-step method. Eur J Clin Pharmacol 2020; 77:677-683. [PMID: 33210160 PMCID: PMC7673685 DOI: 10.1007/s00228-020-03044-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/09/2020] [Indexed: 01/26/2023]
Abstract
Background and methods This opinion paper expanded on the WHO “six-step approach to optimal pharmacotherapy,” by detailed exploration of the underlying pharmacological and pathophysiological principles. This exercise led to the identification of a large number of domains of research that should be addressed to make clinical pharmacology progress toward “precision clinical pharmacology,” as a prerequisite for precision medicine. Result In order to improve clinical efficacy and safety in patient groups (to guide drug development) as well as in individuals (to guide therapeutic options and optimize clinical outcome), developments in clinical pharmacology should at least tackle the following: (1) molecular diagnostic assays to guide drug design and development and allow physicians to identify the optimal targets for therapy in the individual patient in a quick and precise manner (to guide selection of the right drug for the right patient); (2) the setting up and validation of biomarkers of target engagement and modification as predictors of clinical efficacy and safety; (3) integration of physiological PK/PD models and intermediate markers of pharmacological effects with the natural evolution of the disease to predict the drug dose that most effectively improves clinical outcome in patient groups and individuals, making use of advanced modeling technologies (building on deterministic models, machine-learning, and deep learning algorithms); (4) methodology to validate human or humanized in vitro, ex vivo, and in vivo models for their ability to predict clinical outcome with investigational therapies, including nucleic acids or recombinant genes together with vectors (including viruses or nanoparticles), cell therapy, or therapeutic vaccines; (5) methodological complements to the gold-standard, large Phase 3 randomized clinical trial to provide clinically relevant and reliable data on the efficacy and safety of all treatment options at the population level (pragmatic clinical trials), as well as in small groups of patients (as low as n = 1); (6) regulatory science, so as to optimize the ethical review process, documentation, and monitoring of clinical trials, improve efficiency, and reduce costs of clinical drug development; (7) interventions to effectively improve patient compliance and to rationalize polypharmacy for the reduction of adverse effects and the enhancement of therapeutic interactions; and (8) appraisal of the ecological and societal impact of drug use to safeguard against environmental hazards (following the “One Health” concept) and to reduce drug resistance. Discussion and conclusion As can be seen, precision clinical pharmacology aims at being highly translational, which will require very large panels of complementary skills. Interdisciplinary collaborations, including non-clinical pharmacologists, will be key to achieve such an ambitious program.
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Gulmez SE, Aydin V, Akici A. Footprints of Clinical Pharmacology in Turkey: Past, Present, and Future. Clin Ther 2020; 42:351-362. [PMID: 31955969 DOI: 10.1016/j.clinthera.2019.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/21/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
Clinical pharmacology is an interdisciplinary field that encompasses all components of the relationship between drugs and humans. All clinical pharmacology professionals aim to support an improved quality of drug-oriented health services by providing teaching, research, and routine health care services that ensure more tolerable and more effective, suitable, and cost-effective use of drugs. Subsections of clinical pharmacology include clinical trials, pharmacoepidemiology and drug use, pharmacovigilance, pharmacoeconomics, the rational use of medicines, pharmacotherapy consultation, drug monitoring, counseling to authorities and industry, pharmacogenetics, and other practices. By approaching these subsections as part of 3 main aspects of clinical pharmacology-education, research, and health care-this review aims to provide local and international practitioners with detailed information about clinical pharmacology practices in Turkey and to contribute to building the network of communication and collaboration. This review also aims to play an encouraging and pioneering role for Turkey's national community and other countries that have not yet made clinical pharmacology functional in improving the quality of health services, promoting the dissemination of rational use of medicines, helping the set-up of clinical pharmacology organizations, enhancing quantity and quality of the clinical pharmacology workforce, and increasing the infrastructural facilities.
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Affiliation(s)
- Sinem Ezgi Gulmez
- Department of Medical Pharmacology, School of Medicine, Koç University, Istanbul, Turkey.
| | - Volkan Aydin
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ahmet Akici
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
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WHO guide to good prescribing is 25 years old: quo vadis? Eur J Clin Pharmacol 2020; 76:507-513. [PMID: 31938856 DOI: 10.1007/s00228-019-02823-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Twenty-five years ago, the World Health Organization (WHO) published the Guide to Good Prescribing (GGP), followed by the accompanying Teacher's Guide to Good Prescribing (TGGP). The GGP is based on a normative 6-step model for therapeutic reasoning and prescribing, and provides a six-step guide for students to the process of rational prescribing. METHOD We reviewed the need to update both WHO publications by evaluating their use and impact, including new (theoretical) insights and demands. Based on information from literature, Internet, and other (personal) sources, we draw the following conclusions. RESULTS 1. An update of the GGP and TGGP, both in terms of content and form, is necessary because of the current need for these tools (irrational medicine use and unavailability of medicines), the lack of similar documents, and the lack of connection with recent developments, such as Internet and modern education; 2. The basic (6-step) model of the GGP is effective in terms of rational prescribing in the undergraduate situation and is still consistent with current theories about (context) learning, clinical decision-making, and clinical practice; 3. The dissemination and introduction of the GGP and TGGP in education has been successful so far, but is still not optimal because of lack of support and cooperation. CONCLUSIONS On the basis of the evaluation results, a plan for the revision of the GGP and TGGP is presented.
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