A national web-based, problem oriented course on pharmacotherapy for the elderly for newly graduated physicians

抄録

Background

In Sweden, five and a half years of medical studies lead to graduation, whereas another one and a half year of supervised internship, organized under the National Board of Health and Welfare, is needed for a license to practice and the right to freely prescribe medicines. Most medical schools in Sweden today apply an integrated theme based curriculum with no separate courses in pharmacology or pharmacotherapy and, more importantly, no separate examination of prescribing skills. A final, national exam after internship covers general practice, internal medicine, surgery and psychiatry. Again, knowledge in clinical pharmacology or rational prescribing is not assessed separately. Furthermore, final year medical students state that their training in rational prescribing is to limited and that they do not feel confident in prescribing drugs.

Poor quality of the drug treatment in elderly patients has been highlighted in recent years, with the use of medicines unsuitable for the elderly, polypharmacy with an increased risk of unwanted drug interactions, and the lack of clear indications for long term treatment with eg proton pump inhibitors on the one hand, and too little treatment with eg anticoagulants in atrial fibrillation on the other hand.

Aim

With the aim to improve drug treatment of the elderly, the National Board of Health and Welfare, in close collaboration with clinical pharmacology experts at Swedish universities, has developed a national web-based, problem oriented course on pharmacotherapy for the elderly for newly graduated, but not yet licensed, physicians.

Results and discussion

The scope and outline of the course will be presented, together with data on participation and student evaluations and satisfaction of this course, as well as their evaluation of their Clinical pharmacology training at medicinal school. Attempts to evaluate the actual outcome in terms of quality of prescribing will be discussed. Also, the possibilities to integrate this type of course as part of a national examination of prescribing skills will be discussed, in the context of a planned change into six years of medical school with no internship in Sweden.