Geriatric pharmacology and pharmacotherapy education for health professionals and students: a systematic review

Abstract

What is already known about this subject: The rate of medication errors is high, and these errors can cause adverse drug reactions. Elderly individuals are most vulnerable to adverse drug reactions. One cause of medication errors is the lack of drug knowledge on the part of different health professionals. Medical curricula have changed in recent years, resulting in less education in the basic sciences, such as pharmacology.

What this study adds: Our study shows that little curricular time is devoted to geriatric pharmacology and that educational programmes in geriatric pharmacology have not been thoroughly evaluated. While interest in pharmacology education has increased recently, this is not the case for geriatric pharmacology education. Education on geriatric pharmacology should have more attention in the curricula of health professionals, given the often complex pharmacotherapy in elderly patients. Educational topics should be related to the known risk factors of medication errors, such as polypharmacy, dose adjustments in organ dysfunction and psychopharmacotherapeutics.

Aims: Given the reported high rates of medication errors, especially in elderly patients, we hypothesized that current curricula do not devote enough time to the teaching of geriatric pharmacology. This review explores the quantity and nature of geriatric pharmacology education in undergraduate and postgraduate curricula for health professionals.

Methods: Pubmed, Embase and PsycINFO databases were searched (from 1 January 2000 to 11 January 2011), using the terms 'pharmacology' and 'education' in combination. Articles describing content or evaluation of pharmacology education for health professionals were included. Education in general and geriatric pharmacology was compared.

Results: Articles on general pharmacology education (252) and geriatric pharmacology education (39) were included. The number of publications on education in general pharmacology, but not geriatric pharmacology, has increased over the last 10 years. Articles on undergraduate and postgraduate education for 12 different health disciplines were identified. A median of 24 h (from 15 min to 4956 h) devoted to pharmacology education and 2 h (1-935 h) devoted to geriatric pharmacology were reported. Of the articles on education in geriatric pharmacology, 61.5% evaluated the teaching provided, mostly student satisfaction with the course. The strength of findings was low. Similar educational interventions were not identified, and evaluation studies were not replicated.

Conclusions: Recently, interest in pharmacology education has increased, possibly because of the high rate of medication errors and the recognized importance of evidence-based medical education. Nevertheless, courses on geriatric pharmacology have not been evaluated thoroughly and none can be recommended for use in training programmes. Suggestions for improvements in education in general and geriatric pharmacology are given.

Figure 1

Search syntax in PubMed. Equal search strategy in Embase and PsycINFO (limit: 1 January 2000 to 11 January 2011)

Figure 2

Search results with reasons for exclusion. *Exclusion criteria: Non human, animal studies or nonhuman pharmacology education; No pharm educ, content not (pharmacology) education; Pt educ, education for patients or informal caregivers (not health professionals); and Word used diff, the word education is used in a different way from education (e.g. teaching hospital, learning disabilities). † Exclusion criteria: Language, language other than English, German or Dutch. ‡ Exclusion criteria: No description, does not contain objective and quantitative description of pharmacology education; Congress abstr, only congress abstract available without a quantitative description of education; and No full text, not available in full text for screening, despite all efforts, and thus excluded

Figure 3

Relevant articles on pharmacology education and geriatric pharmacology education per year. The three related articles in Figure 2 were from the period before 2000 and are not included. General pharmacology education (); Geriatric pharmacology education ()