Measurement of changes in prescribing ability during dental school education

EN Lia1, CS Moura1, JOS Naves3, EB Coelho2. 1Faculdade de Ciências da Saúde - Universidade de Brasília, Departamento de Odontologia, Brazil, 2Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo, Departamento de Clínica Médica, Brazil, 3Faculdade de Ciências da Saúde - Universidade de Brasília, Departamento de Ciências Farmacêuticas, Brazil

Background: Clinical training for undergraduate dental students often focuses on diagnostic and techniques rather than therapeutic skills. Such attitude cause irrational prescribing leading to ineffective and unsafe treatment and higher costs to health system.

Objective and Methods: The main objective was to evaluate changes on prescribing pattern throughout undergraduate dental school education. A case of non-complicated dental extraction was presented to all students that had been completed pharmacology discipline (from 2nd semester to the last semester). The students were grouped according year of scholarship and were asked to prescribe paracetamol to pain control. A maximal score of 5 points, divided on 3 prescribing skills, i.e., identification of professional and patient (1.0); to give information, instructions and warning about paracetamol use (2.5) and the strength, dosage form and total amount of drug (1.5) were used to evaluate the quality of prescription. The data were expressed as median (IC95%) and were compared using Kruskall-Wallis followed by Dunn post-test. P value <0.05 was considered of statistical significance.

Results: A total of 92 students participated of study (2nd y=13; 3rd y=32; 4th y=28; 5th y=20). The quality of prescription was lower between 2nd year students [2.0 (1.46 – 2.54)] and increased until 4th year [3.20 (2.90 – 3.50), P< 0.05]. There was no difference between 4th and 5th years [3.55 (3.34-3.76), NS]. Lack of information about non-pharmacological treatment, possible adverse effects and administration route were major deficiencies observed.

Conclusions: Although there was an improvement of prescribing ability along undergraduate training in dentistry, deficiencies were noted particularly related with the non-pharmacologic treatment and with drug information, instruction and warnings. Our data suggests that teaching of good prescribing practice should be extended to later stage of undergraduate dental education.