title: The need for a prescribing competency framework to address the burden of complex polypharmacy among multiple long-term conditions.
abstract: The original requirement for a competency framework for prescribers was to identify the essential skills for non-medical prescribers. However, core prescribing competencies are relevant to any prescriber. The new, revised version is especially relevant for doctors/physicians. Doctors are the most frequent prescribers - prescribing is the most common therapeutic intervention. The quantity and complexity of medicine use is increasing through multiple treatment strategies/pathways for multiple comorbidities, resulting in polypharmacy - especially with long-term conditions. This is against a background of the ongoing introduction of new drugs with novel mechanisms of action with increased risks of adverse effects, compounded by drug-drug and disease-drug interactions. This has increased the need for monitoring and follow-up, including identification and management of poor adherence. It is challenging for doctors to maintain safe and effective prescribing and train other doctors and non-medical prescribers within the multidisciplinary team. The prescribing competency framework provides a systematic approach to support doctors to prescribe safely and effectively. It can be used by medical schools to teach prescribing, including preparation for the prescribing safety assessment; by F1/F2 doctors to support prescribing in early years; as part of prescribing quality improvement initiatives and as a continuing professional development framework in general practice or acute care settings.
authors.affiliation: Royal Pharmaceutical Society, London, UK catherinepicton@t-online.de.
authors.forename: Catherine
authors.initials: C
authors.lastname: Picton
authors.affiliation: Northern Ireland Medical and Dental Training Agency, Belfast, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Loughrey
authors.affiliation: King's College London, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Webb
mesh_terms: D002983:Clinical Competence; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000592:standards*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D004501:Education, Medical; D006801:Humans; D061214:Patient Safety; D019338:Polypharmacy
keywords: Competency framework; prescriber; prescribing and competency