I think that the concept you raise of sensitising people to the
issues in prescribing, rather than changing prescribing practices in
a measurable way from a single intervention is going to prove to be
the crux of the matter.
Anecdotally, I came to have an interest in the area of Rational Prescribing
rather by accident, and from a career in ordinary general practice. I
found that even though I was reading and writing about the principles
of good prescribing, I would still find myself reverting to old
habits at times under the pressures which exist in general practice
(lack of time, patient expectations, habits, etc) Over time, and
because I was becoming sensitised to the issues, I think my real
prescribing has improved - certainly I think about it more.
So I think we need to be looking at long term means of changing
prescribing cultures, and not expect single courses or interventions,
no matter how sound, to achieve and maintain significant change. (I
would also like to be proved wrong on this.)
Dr Merilyn Liddell
Department of Community Medicine
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