An agenda for UK clinical pharmacology: Developing and delivering clinical toxicology in the UK National Health Service
Article first published online: 8 MAY 2012
© 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society
British Journal of Clinical Pharmacology
Special Issue: Agenda for Clinical Pharmacology Issue
Volume 73, Issue 6, pages 878–883, June 2012
How to Cite
Thomas, S. H. L. (2012), An agenda for UK clinical pharmacology: Developing and delivering clinical toxicology in the UK National Health Service. British Journal of Clinical Pharmacology, 73: 878–883. doi: 10.1111/j.1365-2125.2012.04229.x
- Issue published online: 8 MAY 2012
- Article first published online: 8 MAY 2012
- Accepted manuscript online: 23 FEB 2012 04:52AM EST
- RECEIVED; 20 June 2011; ACCEPTED; 30 January 2012; ACCEPTED ARTICLE PUBLISHED ONLINE; 23 February 2012
Clinical toxicology concerns the investigation, diagnosis and management of suspected poisoning. It is an important discipline because of the frequency of suspected poisoning, including drug overdose. In the UK, most episodes are managed by nonspecialists, with support provided online or by telephone from the National Poisons Information Service. Leadership and clinical support for this is provided by a small number of clinical toxicologists, who are almost invariably accredited specialists in clinical pharmacology and therapeutics. Priorities for maintaining and enhancing clinical toxicology as a subspeciality in the UK include:
- 1Maintaining funding for poisons centres. This is essential in spite of current budgetary pressures.
- 2Formal training in the discipline. The 1 year optional training module in clinical toxicology approved in 2011 as part of the clinical pharmacology and therapeutics curriculum represents important progress, but funding for appropriate programmes and accreditation for trainees from other relevant disciplines is needed. Arrangements for registration and revalidation are also required.
- 3An improved evidence base for management of poisoning. Priority areas include continued surveillance of the epidemiology and outcomes of poisoning, including syndromic surveillance, more rapid characterization of the human toxicity of newly introduced medicines and better clinical evidence on use of antidotes and other treatments; for example, acetylcysteine and lipid emulsion therapy.