Clinical: Book review - Primary care prescribing

Dr Barney Tinsley reviews a book that aims to provide an insight into the wider issues of prescribing in primary care.

Formal pharmacological teaching can be a bit 'hit and miss', and much is obtained from self- directed learning and ward-based practice.

GPs should ultimately have a 'well-thumbed' formulary, whose prescribing principles are laid down from clinical experience and evidence-based practice.

This book is a valuable insight into the theory and practice surrounding why this is, how it came to be, how it can be effectively continued, and improved upon for the future.

The prescription's journey

Dr Brian Crichton and several colleagues have produced a book that peels back recently laid-down technical layers of evidence-based prescribing and the prescribing incentive scheme, to reveal purity in the first principles of pharmacology and prescriptions.

Early chapters covering historical detail, pharmacological principles and drug development will be of great value to medical students and nurse prescribers/practitioners, particularly helping to answer the 'hows' and 'whys' of pharmacology.

As we proceed through the middle chapters, the roles, formularies and actual prescriptions of the different types of prescriber within the multidisciplinary team are discussed, and placed in conjunction with the consultation process.

The later sections of the book discuss the prescription's journey after issue, and some overall pharmacoeconomics of prescribing. There is also examination of clinical governance within prescribing, with examples of prescribing errors, audit, and negligence. This carefully highlights the need for responsibility and probity from all prescribers.

The final chapter covers continuing education within the field of prescribing, with examples of regional postgraduate courses relevant to primary care prescribers.

Reference text

There is an excellent range of references after each chapter, covering a wide variety of journals as well as key DoH and NICE publications. This emphasises this book's value as a reference text, and would certainly encourage the enthusiastic reader to read more widely in the pharmacological spectrum.


This book would be highly recommended to student doctors during ward-based and community-based placements alike, as well as to nurse prescribers and practitioners as a fundamental learning text.

GP registrars would do well to use this text as an adjunct to practical, managerial and financial aspects of prescribing and pharmacology, and to understand probity and audit.

For those of us on a personal quest for knowledge and personal development, there is plenty in this book to keep us sharp.

- Dr Tinsley is a salaried GP in Bradford

Book giveaway

GP and the RCGP are giving away five copies of Fundamentals of Primary Care Prescribing by Dr Brian Crichton, worth £19.95 each.

For a chance to win a copy, email by 24 October 2008.

If you are unlucky in the book draw then you can order a copy directly from the RCGP website at the price of £19.95

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