What should be updated in the WHO guide to good prescribing?

Abstract

Abstract Purpose Over 30 years ago, the World Health Organization (WHO) published the Guide to Good Prescribing (GGP) with its accompanying six-step model for rational prescribing. While widely used and proven effective in teaching clinical pharmacology and therapeutics (CPT), the GGP has never been revised to reflect scientific, societal, technological, and educational developments. The aim of this study was to explore which elements could be revised to actualize its content. Methods CPT teachers experienced with the GGP were recruited from all six WHO regions. Six online nominal group technique sessions were conducted to elicit and prioritize ideas for revising the GGP. Discussions were audio-recorded, transcribed verbatim, and analyzed using an inductive thematic approach to capture participants’ views on both content and optimal format of the renewed GGP. Results Twenty-six participants shared136 ideas for the revision, grouped into three main areas: ideas about the usability, accessibility, and awareness of the GGP; ideas about the six-step framework; and ideas about background information or supplementary chapters. Suggestions for improving usability emphasized an interactive, digital platform for accessibility, continuous updates, and integrated resources. Regarding the six-step model, participants recommended retaining its structure while incorporating key considerations such as pharmacovigilance, shared decision-making, and deprescribing. Lastly, participants proposed supplementary information on topics such as therapeutic reasoning and special patient populations. Conclusion Suggestions for revising the WHO GGP included integrating contemporary and societal prescribing considerations to enhance its relevance, educational impact and usability, thereby supporting safe and effective prescribing in modern clinical practice.