RATIONAL USE OF MEDICINES: CAN WE PROMOTE

 

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About Authors:
Languluri Reddenna
Department of Pharmacy Practice,
Rajiv Gandhi Institute of Medical Sciences,
Kadapa, Andhra Pradesh, India-516003
reddennapharmd@gmail.com

Abstract
Rational use of drugs can be defined as prescribing the right drug, in sufficient dose for the adequate duration and suitable to the clinical requirements of the patients at least cost. Causes of irrational use comprise not have of knowledge, skills or self-determining information, unhampered accessibility of medicines, overburden of health personnel, unsuitable promotion of medicines and earnings motives from selling medicines. In appropriate drug usecan have dire consequences; it has been associated with hospitalization and evencaused deaths of inpatients in health carefacilities. A variety of situations and circumstancespromote irrational use of medicines. Rational use of medication saves lives, confines undesired toxicity, adverse events and maximize on the benefits that can be imitative from best use of medications. According to surveys conducted in 2004 by HAI Africa and WHO in 11 Sub-Saharan Africa countries in 2004, the average accessibility of the essential medicines in public health facilities was below 70%. Communication between professionals and consumers is essential to the enhancement of rational use of medicines. It is essential to recommence collaboration of physicians and pharmacists concerning accurate and competent drugs prescribing. Governments, private health care institutions, entity health care providers and patients all have an accountability to endorse rational use of medicines. Professionals should provide information to the customers about the name of the medicine, the intention for which the medicine is being taken, dose, frequency of use, and duration of use.

REFERENCE ID: PHARMATUTOR-ART-2140

PharmaTutor (ISSN: 2347 - 7881)

Volume 2, Issue 4

Received On: 11/01/2014; Accepted On: 23/02/2014; Published On: 01/04/2014

How to cite this article: L Redenna, Rational use of Medicines: Can We Promote, PharmaTutor, 2014, 2(4), 43-49

Introduction
Rational use of drugs can be defined as prescribing the right drug, in sufficient dose for the adequate duration and suitable to the clinical requirements of the patients at least cost.[1] The thought of rational drug use throughout the earlier period was the premise of diverse national & international gatherings. A variety of studies conducted in urbanized as well as in budding countries during precedent years concerning the safe & effective use of drugs demonstrate that irrational drug use is a comprehensive occurrence & simply fewprescriptions pretext rational use of drugs.[2] Management with medicines is the majority cost-effective therapeutic interventions recognized and the fraction of nation wide health budget sex hausted on medicines ranges amid 10% and 20% in urbanizedcountries and amid20% and 40% inbudding countries. Over 50% of the entire medicines universal are prescribed, dispensed or sold improperly and 50% of patients not make the grade to take them accurately. Rational drug use attained further consequence currently in terms of therapeutic, socio economical and lawful characteristic. As a result, it is awfully stern with the aim of a lot of medicine is used in animproper and unreason able approach.[3]

Reasons for irrational use of drugs
1. Be short of information
2. Defective, insufficient training and education of HCPs
3. underprivileged communication between HCPs and patient
4. Not have diagnostic services
5. Insist from the patient
6. Substandard drug supply system and hopeless drug regulation
7. Promotional performance of pharmaceutical industries[4]

Types of irrational use of medicines
· Polypharmacy
· Inappropriate use of antibiotics
· Excess use of injections
· Not accordance with clinical guidelines
· Self- medication[5]

People frequently have awfully rational reasonsfor using medicines irrationally. Causes ofirrational use comprise not have of knowledge, skills or self-determining information, unhampered accessibility of medicines, over burden of health personnel, unsuitable promotion of medicines and earnings motives from selling medicines. In the last 20 years progress has been made to promote rational use of medicine. The primary action to correcting irrational use of medicines is to quantify it. On the other hand, rational use of medicines forall medical circumstances is elemental to the prerequisite of wide spread access to satisfactory health care, fulfilment of health-related individual human rights. It is consequently essential that methods taken to progress the rational use of medicines. Since the effort of the precedent 20 years and the confirmation accessible at two international conferences on recuperating the use of medicines (ICIUM 1997 and 2004), greatly is notorious about promotion of rationaluse of medicines. [6]

Mainstay interventions to promote rational use of medicines
· A mandated multi-disciplinary nationalized body to organize medicineuse policies
· Clinical guidelines
· Essential medicines lists based on treatments of choice
· Drugs and therapeutics committees in districts and hospitals
· Problem-based pharmacotherapy training in undergraduate programme
· Progressing in-service medical education as a licensure prerequisite
· Control, audit and comment
· Sovereign information on medicines
· Public education about medicines
· Averting of perverse financial incentives
· Suitable and obligatory regulation[7]

Strategies to promote rational use of medicines

Governments
· Doing a situational investigation
· Assess the impact of programmes in terms ofmedicine use, quality of service and costs
· Means of access with doctors and MPs
· Engage customers and the media
· World Health Organization (WHO) make recommendations to Ministry of Health (MOH)to establish units, with adequate possessions, dedicated promoting rational use of medicines

NGOs
· Campaigner for the benefits of rational use of medicinesfrom public health and financial perspectives
· Comprise a rational use of medicines indicator ineachscheme
· MOH/WHO to organize NGOs in associationwith public, regarding actionspertaining to rational use of medicines

WHO
· Assign personnel in every region with a detailedcommandto work in teamwork with MOHs to endorserational use of medicines
· Maintain countries to launch a division on rational useof medicines within the MOH
· Enterprise advocacy
· Financial statement for actions on rational use of medicines[8]

1. Measuring the impact/obtaining the evidence: Conducting cost benefit analysis; given thatcost implication of irrational drug use; quantifyingthe drug maltreatment; documenting the expenditure in requisites of encumber ofailment, mortality and morbidity due to irrational use.

2. Formation of alliances: Providefacts to communities on the acquaintances between irrationaldrug use and their lack of access to valuable and safe drugs;incorporate RUM needs in development programmes.

3. CommunicationStrategies: Providing regular updates to the mediaon positive messages for RUM; highlighting consequences ofirrational drug use such as deaths from resistant organisms;naming and shaming activities promoting irrational drug use.

4. Empowerment of consumers: Carrying out simple rational drug useactivities within the communities to ensure step by step learningof RUM; providing communities with information to enablethem and grassroots groups to demand appropriate use of theirmedicines.

5. Providing practical messages: Marketing widely the Swedish model onantibiotic use; replicating and publicising the positive ICIUMoutcomes more widely, sharing successful local experienceswithin the country through support of local WHO offices and/orMinistries of Health.

6. Advocacy and lobbying: Making RUM part of training curriculum;making presentation on RUM at all possible venues; providingpoliticians with data for their deliberations in parliament; providingfactual sheets on RUM to lobbyists.

7. Address at global level: Passing of a strong resolution on RUMat the World Health Assembly, allocating of funds for promotingRUM in the budgets, including RUM as a requirement inagreements, addressing RUM as part of strengthening healthsystems.

8. Address industry power: Providing leadership in addressing excessesof the pharmaceutical industry that lead to irrational drug use;holding industry accountable to their social responsibilities.[9]

In appropriate use of medicines is aserious concern, especially when it affects the more vulnerable people and occurs for extended durations. In appropriate drug usecan have dire consequences; it has been associated with hospitalization and evencaused deaths of inpatients in health carefacilities. A variety of situations and circumstances promote irrational use of medicines.[10]

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