AKILCI İLAÇ KULLANIMI EĞİTİMİ UYGULAMA SÜRECİNDE TÜRKİYE’DEKİ TIP FAKÜLTELERİNDE FARMAKOLOJİ ANABİLİM DALLARININ DURUMUNUN İNCELENMESİ

Yıl 2011, Cilt: 29 Sayı: 29, 11 - 20, 01.03.2011

Ahmet Akıcı Ayşe Gelal Aydın Erenmemişoğlu Mehmet Melli Melih Babaoğlu Şule Oktay

Öz

Aim: We aimed to determine the success rate of the courses, which were planned to educate the trainers on problem based rational pharmacotherapy (RP) for the education of medical school students and evaluate the experiences of the pharmacology departments which performed this education. Methods: A questionnaire was sent to all pharmacology departments of the medical schools (n=42) between September 2006 - April 2007 and the data were recruited by the evaluation of those which were replied (n=37). In the questionnaire, educational substructures of the pharmacology departments and the experiences of RP trainers were inquired. To those departments unable to give RP education, the justifications for this failure and their future plans were asked. Results: We found that 27.8 % of the 288 staff members underwent RP trainer education, and 70.3 % of the pharmacology departments give RP education to medical students and69.2 % of the departments have started RP education relatively recent (less than 5 years); 69.2 % of them give this education to groups of 10 to 19 students; 63.6 % of them evaluate the education using objective structured clinical examinations; 95.5 % receive feedback from the students. The main reasons for the failure to give RP education were lack of educated staff members and discordant curriculum. Conclusion: It is evident that most of the staff members who had attended problem based RP trainer education have succeeded to perform this education in their schools. It would be useful to repeat the RP trainer education at certain intervals in order to make problem based RP education more widespread among medical students.

Anahtar Kelimeler

Rational pharmacotherapy, medical school, pharmacology, undergraduate education

AKILCI İLAÇ KULLANIMI EĞİTİMİ UYGULAMA SÜRECİNDE TÜRKİYE’DEKİ TIP FAKÜLTELERİNDE FARMAKOLOJİ ANABİLİM DALLARININ DURUMUNUN İNCELENMESİ

Öz

Amaç: Tıp fakültelerinde mezuniyet öncesi probleme dayalı akılcı ilaç kullanımı (AİK) eğitimi için düzenlenmiş olan eğitici eğitimlerinin hedefine ne ölçüde ulaştığı, farmakoloji anabilim dallarının (AbD) bu konuya yaklaşımları ve AİK eğitimi uygulayan farmakoloji AbD’nın deneyimlerinin incelenmesi amaçlandı. Yöntem: Veriler Eylül 2006 - Nisan 2007 tarihleri arasında ülkemizdeki tüm tıp fakülteleri farmakoloji AbD başkanlıklarına (n=42) iletilip yanıt alınan (n=37) anket sonuçlarının değerlendirilmesi ile elde edildi. Ankette özetle farmakoloji AbD’nın eğitimi ilgilendiren imkanları; AİK eğitimi verenlerin deneyimleri; AİK eğitimi veremeyenlerin gerekçeleri ve planları sorgulandı. Bulgular: Toplam 288 öğretim üye ve yardımcısının %27.8’inin AİK eğitici eğitimi aldığı ve farmakoloji AbD’larının %70.3’nün AĐK eğitimini mezuniyet öncesi eğitim içerisinde uyguladığı saptandı. Fakültelerde AĐK eğitimine nispeten “yeni” başlanmış olduğu (%69.2’si 5 yıldan az), çoğunluğunun 10-19 kişilik öğrenci gruplarında (%69.2) bu eğitimi uyguladığı ve %63.6’sının eğitimi objektif yapılandırılmış sınavlarla değerlendirdiği, %95.5’inin ise geri bildirim aldığı saptandı. AİK eğitimini uygulayamayanlar arasında “eğitici eğitimi almış öğretim elemanı yetersizliği”ni ve “fakültelerinin müfredatının yetersizliği”ni gerekçe gösterenlerin çoğunlukta oldukları görüldü. Sonuç: AİK eğitici eğitimi almış olanların fakültelerinde AİK eğitimini çoğunlukla uygulamayı başardığı görülmektedir. AİK eğitimi veremeyen farmakoloji AbD’larında da bu sürecin başlatılabilmesi için eğitici eğitimlerinin belirli aralıklarla tekrarlanması yararlı olacaktır.

Anahtar Kelimeler

Akılcı ilaç kullanımı, tıp fakültesi, farmakoloji, mezuniyet öncesi eğitim

Kaynakça

• De Vries TPGM, Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing. WHO/Action programme on essential drugs, Geneva, 1994.
• Promoting rational drug use. Trainer’s guide. Accra, Ghana; 15-27 Kasım 1998
• WHO/DAP. How to investigate drug use in health facilities: selected drug use indicators. Geneva. World Health Organization. 1993. WHO / DAP / 93.1.
• WHO/EDM/PAR. Teacher’s guide to good prescribing. World Health Organization Essential Drugs and Medicines Policy Geneva. 2001 WHO/EDM/PAR/2001.2
• Walley T, Bligh J. The educational challenge of improving prescribing. Postgrad Edu Gen Prac 1993;4:50-54.
• Ro Laing, Hogerzeil HV, Ross-Degnan D. Ten recommendations to improve use of medicines in developing countries. Health Policy and Planning 2001;16(1):13-20.
• Le Grand A, Hogerzeil HV, Haaijer-Ruscamp FM. Intervention research in rational use of drugs: a review. Health Policy and Planning 1999;14:89-102.
• Akici A, Kalaça S, Gören MZ, Akkan AG, Karaalp A, Demir D, Uğurlu Ü, Oktay Ş. Comparison rational pharmacotherapy decision making competence of general practitioners with intern doctors. Eur J Clin Pharmacol 2004;60:75-82.
• Karaalp A, Akici A, Kocabasoglu YE, Oktay S. What do the graduates think about the two-week rational pharmacotherapy course at the 5th year of their medical education? Medical Teacher 2003;25(5):515-521.
• Akici A, Kalaca S, Ugurlu MU, Karaalp A, Çalı S, Oktay S. Impact of a short postgraduate course in rational pharmacotherapy for general practitioners. Br J Clin Pharmacol 2004;57(3):310 – 321.
• Akici A, Gören MZ, Aypak C, Terzioğlu B, Oktay S. Prescription audit adjunct to rational pharmacotherapy education improves prescribing skills of medical students. Eur J Clin Pharmacol 2005;61(9):643-50.
• Hassan NAGM, Abdulla AA, Bakathir HA, Al-Amoodi AA, Aklan AM, TPGM de Vries. The impact of problem- based pharmacotherapy training on the competence of rational prescribing of Yemen undergraduate students. Eur J Clin Pharmacol 2000;55:873-876.
• De Vries TPGM. Presenting clinical pharmacology and therapeutics: a problem based approach for choosing and prescribing drugs. Br J Clin Pharmacol 1993;35:581-586.
• De Vries TPGM. Presenting clinical pharmacology and therapeutics: General introduction. Br J Clin Pharmacol 1993;35:577-579.
• De Vries TPGM. Presenting clinical pharmacology and therapeutics: evaluation of a problem based approach for choosing drug treatments. Br J Clin Pharmacol 1993;35:591-597.
• De Vries TPGM, Henning RH, Hogerzeil HV, et al. Impact of a short course in pharmacotherapy for undergraduate medical students: an international randomized controlled study. Lancet 1995;346:1454-1457.
• Veninga CCM, Lagerlov P, Wahlström R, et al. Evaluating an educational intervention to improve the treatment of asthma in four European countries. Am J Respir Crit Care Med 1999;160:1254-1262.
• Veninga CCM, Lundborg CS, Lagerlov P, Hummers-Pradier E, Denig P, Haaijer-Ruskamp FM. Treatment of uncomplicated urinary tract infections: exploring differences in adherence to guidelines between three European countries. Ann Pharmacother 2000a;34:19-26.
• Veninga CCM, Denig P, Zwaagstra R, Haaijer-Ruskamp FM. Improving drug treatment in general practice. J Clin Epidemiol 2000b;53:762-772.
• Lagerlov P, Veninga CCM, Muskova M, et al. Asthma management in five European countries. Eur Respir J 2000;15: 25-29.
• Lagerlov P, Loeb M, Andrew M, Hjortdahl P. Improving doctors’ prescribing behavior through reflection on guidelines and prescription feedback: a randomized controlled study. Quality in Health Care 2000;9:159-165.
• Tomson Y, Hasselström J, Tomson G, Aberg H. Asthma education for Swedish primary care physicians- a study on the effects of “academic detailing” on practice and patient knowledge. Eur J Clin Pharmacol 1997;53:191-196.
• Oktay Ş. Bir toplantının ardından: “Türkiye’de rasyonel ilaç kullanımı ilkelerinin yerleştirilmesinde farmakoterapi eğitimi ve klinik farmakolojinin yeri” çalışma toplantısı. Kızılcahamam, Ankara 28-29 Eylül 1999 . Türk Farmakoloji Derneği Bülteni 57, Kasım-Aralık 1999
• Newble D, Cannon R. A Handbook for Medical Teachers. Ed: Kapelis Z. Third Ed. Kluwer Academic Publ. Dordrecht, The Netherlands, 1994.