1. Impact of WHO Guide to Good Prescribing on Medical Students Abdelkader Helali*, Nadjat Loumi* *: Centre National de Pharmacovigilance et de Matériovigilance. Algiers (Algeria) ICIUM 2011, Antalya Nov 14th – 18th 2011

2. Objectives: To measure the impact of the WHO Guide of Good Prescribing a model with 6 steps to improve students’ reasoning and solving capabilities in pharmacotherapy with a study over a 3 years (to insure data reproducibility); To discuss the inter- relationship between pharmacotherapy and other disciplines for more openness and pro-active approach in finding allies and forming multidisciplinary coalitions. Study population: Students at the 6th year undergraduate Algiers’ Faculty of Medicine (Algeria). Intervention: 198 Students, randomly selected on voluntary basis, divided into 2 groups: a control group with 65 students and study group with 133 students. Training: Students were invited to prescribe to relief symptomatic pain (migraine, acute hepatic colic, acute renal colic, arthritis, irritable bowel syndrome, acute pharyngitis) ICIUM 2011, Antalya Nov 14th – 18th 2011 Tests: 3 open problems (A, B, C) and 3 structured problems (X, Y, Z) was successively presented. Scoring of tests: 1= no answer, 2= poor answer, 3= arguable answer, 4= acceptable answer, 5= good answer

3. Design of the study 1 Study testsOpen problemsStructured problems Measurements Remembering the WHO method learned (Retention effect) Applying the method to new patient cases (transfer effect) Students were guided in the reasoning process (knowledge on drug treatment) Pre study test (T 0 ) Test before training period. A-X Study test (T 1 ) 8 weeks later, after training period ABY Post study test (T 2 ) 4 weeks after the end of training period ACZ 1: Adapted from TPGM de Vries, RH Henning, JS Bapna, HV Hogerzeil & al. Lancet 1995; 346: 1454-57 ICIUM 2011, Antalya Nov 14th – 18th 2011

4. T 0 : Prestudy test Control Group Study Group T 1 : Test immediately after the training period of 8 weeks T 2 : Test 4 weeks later (remembering of method) Control Group * P < 0.05 Y: Years of the study ICIUM 2011, Antalya Nov 14th – 18th 2011 Problem A Problems X,Y,Z Problems B, C y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 y1y1 y2y2 y3y3

5. T 0 : Prestudy test Control Group Study Group T 1 : Test immediately after the training period of 8 weeks T 2 : Test 4 weeks later (remembering of method) Control Group * P < 0.05 Y: Years of the study ICIUM 2011, Antalya Nov 14th – 18th 2011 Problem A Problems X,Y,Z Problems B, C * * ** * * * * * * * * * * * * * * y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 y1y1 y2y2 y3y3

6. T 0 : Prestudy test Control Group Study Group T 1 : Test immediately after the training period of 8 weeks T 2 : Test 4 weeks later (remembering of method) Control Group * P < 0.05 Y: Years of the study ICIUM 2011, Antalya Nov 14th – 18th 2011 Problem A Problems X,Y,Z Problems B, C * * * * * * * * * * * * * * * * * * y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 y1y1 y2y2 y3y3

7. T 0 : Prestudy test Control Group Study Group T 1 : Test immediately after the training period of 8 weeks T 2 : Test 4 weeks later (remembering of method) Control Group * P < 0.05 Y: Years of the study ICIUM 2011, Antalya Nov 14th – 18th 2011 Problem A Problems X,Y,Z Problems B, C * * * * * * * * * * ** * * * * * y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 y1y1 y2y2 y3y3

8. T 0 : Prestudy test Control Group Study Group T 1 : Test immediately after the training period of 8 weeks T 2 : Test 4 weeks later (remembering of method) Control Group * P < 0.05 Y: Years of the study ICIUM 2011, Antalya Nov 14th – 18th 2011 Problem A Problems X,Y,Z Problems B, C * * * * * * * * * * * * * * * * * * y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 y1y1 y2y2 y3y3

9. T 0 : Prestudy test Control Group Study Group T 1 : Test immediately after the training period of 8 weeks T 2 : Test 4 weeks later (remembering of method) Control Group * P < 0.05 Y: Years of the study ICIUM 2011, Antalya Nov 14th – 18th 2011 Problem A Problems X,Y,Z Problems B, C * * ** * * * * * * * * * * * * * y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 y1y1 y2y2 y3y3 *

10. Policy implication 1.Foster a critical thinking, self-directed learning and use of multidisciplinary inputs to bridge the gap between fundamental sciences, clinical practice, critical analysis, social and behavioural sciences for more rational prescribing and uses ; 2.Prepare the students to become a part of the healthcare system and develop their skills. Prepare them to Investigate Drug Use in their health facilities by using selected drug use indicators for identifying their needs and planning for continuous training and better use of medicines ; 3.Make students ready to understand community needs for safe practice and provide with Epidemiology, Method for Selecting Essential Medicines List at their health facilities or at country level, developing a Personal Formulary to become more competent in prescribing. Future study and Research 1.Comparative multicentre studies of cost-effectiveness of teaching WHO Guide of Good Prescribing as short term pharmacotherapy training in different setting in undergraduate medical education in low and middle income countries. 2.Foster Multidisciplinary looking at prescribing practice at real life scenarios (not only at simulated cases). 3.Promote drawing up a Model Core Curriculum for undergraduate medical students using WHO Good Prescribing on the basis of WHO Model Essential Medicines List adjusted to the country needs. ICIUM 2011, Antalya Nov 14th – 18th 2011