Document Type : Original Article
Authors
1 Professor, Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Research and Development Office, Vice Chancellery for Food and Drug, Isfahan University of Medical Sciences, Isfahan, Iran
3 M.Sc., Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
4 Associate Professor, Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Holdingcontinuing medical education programs (CME) is one of the recommended global strategies for attaining rational drug prescribing by physicians. The aim of this study was to assess the barriers and fill the gap between the current situation and the favorable status of CME by evaluating experts’ viewpoints on the role of these programs in improving the status of drug prescribing.
Methods: This qualitative study was conducted using a semi-structured interview. Participants included those who were well-informed and experienced in the field of rational use and prescribing drugs. Sampling was done in a targeted way and 16 people were interviewed. The interviews were evaluated after the implementation of the theme analysis method.
Results: In this study, two major concepts including the needs for CME and barriers to effective CME were presented by the participants. The needs for CME included 4 main themes, and the barriers to effective CME included 6 themes (physical, financial, motivational, supervisional, executive, and policy making barriers) and 12 sub themes.
Conclusion: Regarding the multiple barriers to achieving the effective CME and improving the rational drug prescribing, and in order to overcome these barriers and achieve a favorable status, a review of the content and quality of CME, outcome-based planning, and continuous quality promotion are required.
Keywords
- Marandi A. Health in the Islamic Republic of Iran. Medical Education. 1997; 5(30): 370-5 (In Persian).
- WHO. Policy Perspectives on medicines: Promoting rational use for medicine: Core components; 2002; Geneva, Switzerland.
- Camacho SM, Lopez M, Bron JE, Shinn AP. An assessment of the use of drug and non-drug interventions in the treatment, a protozoan parasite of freshwater fish. Parasitology. 2012; 139(2): 149-90.
- Theodorou M, Tsiantou V, Pavlakis A, Maniadakis N, Fragoulakis V, Pavi E, et al. Factors influencing prescribing behavior of physicians in Greece and Cyprus: results from a questionnaire based survey. BMC Health Services Research. 2009; 9(1): 150-8.
- Ghahremani H. How to prevent overuse of drugs. Journal of Guilan University of Medical Sciences. 2004; 50: 4-9 (In Persian).
- Ghorbani M, Hosseini SM, Khori V. Investigating the effectiveness of face to face education on decreasing drug interaction in 2005/2006 autumn and winter prescriptions of insurance institutes. Journal of Azad Islamic University. 2007; 17(3): 171-5 (In Persian).
- Esmaily HM, Savage C, Vahidi R, Amini A, Zarrintan MH, Wahlstrom R. Identifying outcome-based indicators and developing a curriculum for a continuing medical education programme on rational prescribing using a modified Delphi process. BMC Medical Education. 2008; 8: 33.
- Amini A, Kargarmaher MH, HatamiSadabadi F, Salami H. Determining CME needs of general physicians in East Azerbijan provinc. Iranian Journal of Medical Education. 2002; 1(8): 12-13 (In Persian).
- Shirazi M, Zeinaloo AA, Sabouri-Kashani A, Alaeddini F. Assessing the gap between current and desirable needs in TUMS CME Unit: participants' viewpoints. Journal of Medical Education. 2004; 5(1): 17-22.
- Forsetlund L, Bjّrndal A, Rashidian A, Jamtvedt G, O’Brien MA, Wolf FM, et al. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Systematic Review. 2009; 2: CD003030.
- Abedijafari H, Taslimi MS, Faghihi A, Sheikhzadeh M. Thematic analysis and thematic network: the simple and efficient way for explain existence patterns in qualitative data. 5th Ed. Tehran: Andisheh Modiriat Rahbordi. 2011; 10(2): 151-198 (In Persian).
- Kamarudin G, Penm J, Chaar B, Moles R. Educational interventions to improve prescribing competency: a systematic review. British Medical Journal. 2013; 3(8): e003291.
- Thomas M, Cherian AM, Mathai D. Measuring the impact of focused workshops on rational drug use. Tropical Doctor. 1997; 27(4): 206-10.
- Santoso B, Suryawati S, Hadiyono JEP, Danu SS, Sunartono B. Interactional group discussion: results of a controlled trial using a behavioral intervention to reduce the use of injections in public health facilities. Social Science & Medicine. 1996; 42: 1185-86.
- Kahan NR, Kahan E, Waitman DA, Kitai E, Chintz DP. The tools of an evidence-based culture: implementing clinical-practice guidelines in an Israeli HMO. Academic Medicine. 2009; 84: 1217-25.
- Butler CC, Simpson SA, Dunstan F, Rollnick S, Cohen D R, Gillespie D, et al. Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomized controlled trial. British Medical Journal. 2012; 344:
- Esmaily HM, Silver I, Shiva S, Gargani A, Maleki-Dizaji N, Al-Maniri A, et al. Can rational prescribing be improved by an outcome-based educational approach? A randomized trial completed in Iran. Journal of Continuing Education in the Health Professions. 2010; 30(1): 11-18.
- Garjani A, Salimnejad M, Maleki N. The Effect of interactive group discussion among physicians to promote rational use of drugs. Journal of Medical Education. 2006; 8(2): 73-81.
- Vahidshahi K, Mahmoudi M, Shahbaznezhad L, Ghafari-Saravi V. The viewpoints of general physicians toward continuing medical education programs' implementation status and the participants' motivation. Iranian Journal of Medicine. 2007; 7(1): 161-7.
)