BMJ Open 3:e003291 doi:10.1136/bmjopen-2013-003291
  • Medical education and training
    • Research

Educational interventions to improve prescribing competency: a systematic review

  1. Rebekah Moles
  1. Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, New South Wales, Australia
  1. Correspondence to Dr Rebekah Moles; rebekah.moles{at}
  • Received 23 May 2013
  • Revised 20 July 2013
  • Accepted 24 July 2013
  • Published 30 August 2013


Objective To review the literature on educational interventions to improve prescribing and identify educational methods that improve prescribing competency in both medical and non-medical prescribers.

Design A systematic review was conducted. The databases Medline, International Pharmaceutical Abstracts (IPA), EMBASE and CINAHL were searched for articles in English published between January 1990 and July 2013.

Setting Primary and secondary care.

Participants Medical and non-medical prescribers.

Intervention Education-based interventions to aid improvement in prescribing competency.

Primary outcome Improvements in prescribing competency (knows how) or performance (shows how) as defined by Miller's competency model. This was primarily demonstrated through prescribing examinations, changes in prescribing habits or adherence to guidelines.

Results A total of 47 studies met the inclusion criteria and were included in the systematic review. Studies were categorised by their method of assessment, with 20 studies assessing prescribing competence and 27 assessing prescribing performance. A wide variety of educational interventions were employed, with different outcome measures and methods of assessments. In particular, six studies demonstrated that specific prescribing training using the WHO Guide to Good Prescribing increased prescribing competency in a wide variety of settings. Continuing medical education in the form of academic detailing and personalised prescriber feedback also yielded positive results. Only four studies evaluated educational interventions targeted at non-medical prescribers, highlighting that further research is needed in this area.

Conclusions A broad range of educational interventions have been conducted to improve prescribing competency. The WHO Guide to Good Prescribing has the largest body of evidence to support its use and is a promising model for the design of targeted prescribing courses. There is a need for further development and evaluation of educational methods for non-medical prescribers.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

blog comments powered by Disqus