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A pilot survey of junior doctors’ attitudes and awareness around medication review: time to change our educational approach?
  1. Barry Jubraj1,2,
  2. Vanessa Marvin1,2,
  3. Alan J Poots2,
  4. Shreena Patel3,
  5. Iñaki Bovill4,
  6. Nina Barnett5,
  7. Laurel Issen2,
  8. Derek Bell2
  1. 1Pharmacy Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  2. 2National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Northwest London (CLAHRC NWL), London, UK
  3. 3Department of Pharmacy, King's College London, London, UK
  4. 4Department of Medicine for the Elderly, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  5. 5Pharmacy Department, London North West Healthcare NHS Trust (Northwick Park Hospital), London, UK
  1. Correspondence to Dr Alan J Poots, National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Northwest London (CLAHRC NWL), London SW10 9NH, UK; a.poots{at}imperial.ac.uk

Abstract

Objectives Our aim was to explore junior doctors’ attitudes and awareness around concepts related to medication review, in order to find ways to change the culture for reviewing, altering and stopping inappropriate or unnecessary medicines. Having already demonstrated the value of team working with senior doctors and pharmacists and the use of a medication review tool, we are now looking to engage first year clinicians and undergraduates in the process.

Method An online survey about medication review was distributed among all 42 foundation year one (FY1) doctors at the Chelsea and Westminster Hospital NHS Foundation Trust in November 2014. Descriptive statistics were used for analysis.

Results Twenty doctors completed the survey (48%). Of those, 17 believed that it was the pharmacist's duty to review medicines; and 15 of 20 stated the general practitioner (GP). Sixteen of 20 stated that they would consult a senior doctor first before stopping medication. Eighteen of 20 considered the GP and consultant to be responsible for alterations, rather than themselves. Sixteen of 20 respondents were not aware of the availability of a medication review tool. Seventeen of 20 felt that more support from senior staff would help them become involved with medication review.

Conclusions Junior doctors report feeling uncomfortable altering mediations without consulting a senior first. They appear to be building confidence with prescribing in their first year but not about the medication review process or questioning the drugs already prescribed. Consideration should be given to what we have termed a ‘bottom-up’ educational approach to provide early experience of and change the culture around medication review, to include the education of undergraduate and foundation doctors and pharmacists.

  • Deprescribing
  • medication review
  • stopping medicines
  • junior doctors

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