Physicians' clinical judgment cannot reliably predict medication harm, study finds

Clinical judgement of physicians does not serve as a reliable tool to predict medication-related harm in older adults after being discharged from the hospital, a study in British Journal of Clinical Pharmacology found.

The study involved five teaching hospitals in England between September 2013 and November 2015 and included 1,066 patients with completed predictions and follow-up.

The researchers asked physicians discharging older patients to estimate the likelihood of their patient experiencing medication-related harm and requiring care in the eight-week period post-discharge.

Junior physicians with less than five years of clinical experience made the majority of predictions (85 percent). The study found no relationship between physicians' predictions and medication-related harm, regardless of physician experience.

The study found physicians' predictions were more likely to be correct when they reported higher confidence in their prediction, particularly with predicting hospital readmissions linked to medication-related harm.

"These findings confirm the complexity of predicting medication-related harm. This makes it very challenging to target medication-related strategies to the right individuals," said Khalid Ali, MD, chief study investigator. "Clinical pharmacology and therapeutics teaching has not been particularly prominent in undergraduate medical training. This is perhaps an area requiring review, given an aging population that is prescribed ever increasing quantities of medicine."

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