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Essential
Practical
Prescribing

Georgia Woodfield MBChB MRCP
Specialist Registrar in Gastrointestinal Medicine, London

Benedict Lyle Phillips MBChB BSc (Hons) MRCS MSc
Specialist Registrar in General Surgery, NE London Deanery

Victoria Taylor MBChB BSc MRCP
Specialist Registrar in Respiratory Medicine, London

Amy Hawkins BA (Hons) MBChB (Hons) MRCP MSc
Specialist Registrar in Palliative Medicine, London

Andrew Stanton MD FRCP
Consultant Respiratory Physician
The Great Western Hospital, Swindon;
Honorary Senior Clinical Lecturer, University of Bristol

With contribution from Marie O'Sullivan MB ChB
Specialist Registrar in Obstetrics & Gynaecology, Severn Deanery



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Preface

This textbook was inspired by the need for a practical prescribing textbook for medical students and junior doctors. In a 2009 General Medical Council (GMC) report, 9% of hospital prescriptions contained errors, where 18.7% of these were made by junior doctors (Dornan et al., 2009). A 2008 GMC report of newly qualified UK doctors showed that prescribing was the ‘main area of practice in which errors were reported by respondents, indicating a significant potential risk’ (Illing et al., 2008). Aside from these figures, the initial inspiration for the book came from my own and others' personal experiences of being a doctor training in busy UK hospitals. Starting as a doctor is daunting, particularly due to the sudden weight of responsibility, much of which lies in prescribing medications. A National Patient Safety Agency study in 2007 found that 32% of the most serious UK drug error incidents were caused by prescribing (NPSA, 2009). When I (GW) started I would have certainly found a practical prescribing book beneficial, as common prescriptions do not become embedded in your memory until you have had the experience to draw back on.

Later on, whilst teaching medical students in the Great Western Hospital Swindon, it became clear that many were worried about becoming junior doctors, where prescribing was a major theme. I and the co-authors (working as clinical teaching fellows or with regular teaching roles) therefore ran prescribing tutorials for medical students, and received hugely positive feedback from them. This encouraged us to publish the data from the tutorials, present at conferences and ultimately write this textbook.

We believe our textbook fills a gap in a critical subject area by relating to medical students and junior doctors in a practical and accessible way. We have tried to ensure this by basing it on our own experiences as junior doctors. It is concise enough to be used as a ward guide, particularly as the DRUGS Checklists provide a quick summary of how to write prescriptions. The book also contains MCQs on a companion website (see the link at the end of each chapter) for those revising for the Prescribing Skills Assessment or wanting to test their knowledge. The website also has easily accessible DRUGS Checklist boxes, where important information is condensed for ease of reference.

We hope this book helps you to avoid mistakes, learn tips from doctors who have gone before you and be the best doctor you can be. Good Luck!

Georgia Woodfield
Benedict Lyle Phillips
Victoria Taylor
Amy Hawkins
Andrew Stanton

Reference

Dornan T, Ashcroft D, Heathfield H et al. (2009). Final report. An in Depth Investigation into Causes of Prescribing Errors by Foundation Trainees in Relation to their Medical Education. Equip Study. Available at: www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdf (accessed Dec. 2015).

Illing J, Morrow G, Kergon C et al. (2008). How Prepared are Medical Graduates to Begin Practice? A Comparison of Three Diverse UK Medical Schools. Available at: www.gmc-uk.org/FINAL_How_prepared_are_medical_graduates_to_begin_practice_September_08.pdf_29697834.pdf (accessed Dec. 2015).

NHS National Patient Safety Agency (NPSA) (2009). National Reporting and Learning Service. Safety in Doses Improving the Use of Medicines in the NHS. Learning from National Reporting 2007. Available at: www.nrls.npsa.nhs.uk/resources/?entryid45=61625 (accessed Dec. 2015).

Acknowledgements

We are most grateful to a number of our colleagues from the Great Western Hospital, the University of Bristol and London for their time and expertise in reviewing and providing valuable comments and suggestions to improve sections of the book.

Chapter 2 Emergency Department: Dr Clare Taylor, Emergency Medicine Consultant at the Royal United Hospitals, Bath

Chapter 3 Cardiology: Dr Andrianos Kontogeorgis, Senior Clinical Fellow in Cardiology and Electrophysiology at the Royal Brompton Hospital, London

Chapter 5 Gastroenterology: Dr Ajeya Shetty, Gastroenterology Consultant at the Great Western Hospital, Swindon

Chapter 6 Neurology: Dr Stephan Hinze, Neurology Consultant at the Great Western Hospital, Swindon

Chapter 7 Surgery: Dr Tony Pickworth, Consultant Anaesthetist at the Great Western Hospital Swindon

Chapter 8 Care of the Elderly: Dr Sameer Maini, Care of the Elderly Consultant at the Great Western Hospital, Swindon

Chapter 9 Anticipatory Prescribing at the End of Life: Professor Karen Forbes, Palliative Medicine Consultant at the University Hospitals, Bristol

Chapter 10 Renal: Dr Gavin Dreyer, Specialist Registrar in Nephrology in the NE London Deanery, Dr Rhys Evans, Specialist Registrar in Nephrology in the NE London Deanery and Dr Ulla Hemmilä, Specialist Registrar in Nephrology in the NE London Deanery

Chapter 11 Microbiology: Dr Robert Baker, Microbiology Consultant at the Musgrove Park Hospital, Taunton

Chapter 12 Rheumatology: Dr Lyn Williamson, Rheumatology Consultant at the Great Western Hospital, Swindon

Chapter 13 Dermatology: Dr Sam Gibbs, Dermatology Consultant at the Great Western Hospital, Swindon

Chapter 14 Obstetrics and Gynaecology: Mr Kevin Jones, Obstetrics and Gynaecology Consultant at the Great Western Hospital, Swindon

Chapter 15 Diabetes: Professor Andy Levy, Consultant Endocrinologist, University Hospitals, Bristol

Thank you also to Dr Stanton for believing in us and supporting us every step of the way.

About the Companion website

Don't forget to visit the companion website for this book:


www.wileyessential.com/prescribing

There you will find valuable material designed to enhance your learning, including:

  1. MCQs
  2. Downloadable DRUGS checklists

Scan this QR code to visit the companion website