Indicators related to the rational use of medicines and its associated factors

OBJECTIVE: To evaluate indicators related to the rational use of medicines and its associated factors in Basic Health Units. METHOD: This is a cross-sectional study carried out in a representative sample of Brazilian cities included in the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). The data were collected by interviews with users, medicine dispensing professionals, and prescribers; and described by prescription, dispensing, and health services indicators. We analyzed the association between human resources characteristics of pharmaceutical services and dispensing indicators. RESULTS: At national level, the average number of medicines prescribed was 2.4. Among the users, 5.8% had antibiotic prescription, 74.8% received guidance on how to use the medicines at the pharmacy and, for 45.1% of users, all prescribed medicines were from the national list of essential medicines. All the indicators presented statistically significant differences between the regions of Brazil. The dispensing professionals that reported the presence of a pharmacist in the unit with a working load of 40 hours or more per week presented 1.82 more chance of transmitting information on the way of using the medicines in the dispensing process. CONCLUSION: The analysis of prescription, dispensing, and health services indicators in the basic health units showed an unsatisfactory proportion of essential medicines prescription and limitations in the correct identification of the medicine, orientation to the patients on medicines, and availability of therapeutic protocols in the health services

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Study of knowledge, attitude, practice of rational use of medicines among interns at Mc Gann teaching district hospital, Shivamogga- a descriptive cross-sectional study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20211645 ◽

2021 ◽

Vol 10 (5) ◽

pp. 512

Author(s):

Vedavathi Hanumaiah ◽

Shreenivas Revankar ◽

Abhishek C. P.

Keyword(s):

Final Analysis ◽

Cross Sectional Study ◽

Essential Medicines ◽

Fixed Dose ◽

Sectional Study ◽

Cross Sectional ◽

Rational Use ◽

Rational Use Of Medicines ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Background: Rational use of medicines requires that the patients receive medication appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of lime, and at the lowest cost to them and to their community. Objective of the study were like descriptive cross- sectional study was conducted to determine and identify the level of knowledge, attitude and practice regarding rational use of medicines among the interns.Methods: A validated structured questionnaire containing 19 questions regarding rational use of medicines in knowledge, attitude and practice (KAP) format was distributed in hand among 109 interns affiliated to this institution. Descriptive statistics were used to illustrate the results in the form of number and percentage.Results: Out of 109 interns, 102 completed the questionnaire and were included in the final analysis. Majority of interns who participated in study were aware of the concept of rational use of medicine but the knowledge related to EML (essential medicines list), P drugs, schedule H drugs and number of FDCs (fixed dose combination) in EML was limited.Conclusions: As interns are future prescribers, they need to be aware of all the aspects of rational use of medicine and there is need to emphasise on learning module and training programs to ensure the interns have knowledge of rational use of medicines.

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Satisfação dos usuários com a atenção à saúde bucal em Pauini, Amazonas, Brasil

Journal of Dentistry & Public Health ◽

10.17267/2596-3368dentistry.v11i2.3354 ◽

2020 ◽

Vol 11 (2) ◽

pp. 121

Author(s):

Gustavo Sobreira Folhadela ◽

Lauramaris De Arruda Regis Aranha ◽

Adriana Beatriz Silveira Pinto ◽

Shirley Maria De Araújo Passos ◽

Angela Xavier Monteiro

Keyword(s):

Oral Health ◽

Health Services ◽

User Satisfaction ◽

Dental Health ◽

Access To Health Services ◽

Public Health Services ◽

Cross Sectional ◽

Basic Health ◽

Oral Health Services ◽

Basic Health Units

OBJECTIVE: This study aimed to understand user satisfaction with the Oral Health Team of Basic Health Units in the municipality of Pauini, Amazonas. MATERIAL AND METHOD: This cross-sectional study was conducted between December 2019 and February 2020 in the three basic health units in the urban area of the municipality and had as participants the users of dental health services. Two questionnaires were used: the first to assess access to health services and the other about user satisfaction with oral health care. The results were analyzed descriptively by means of absolute and relative frequencies. RESULTS: Participated in the study 265 individuals, and when asked how scheduling was done, 61.51% replied that it was through a visit to the health unit, and with regard to the main reason for the last consultation, 47.17% of users replied that the main reasons were toothache and extraction. The highest percentages of satisfaction it were found in the physical structure domain and the domain with the lowest percentages information and support. CONCLUSION: The results showed the need to improve the form of access to dental public health services and a positive perception by the users of oral health services in Pauiní, AM, however, the best results were observed in the infrastructure of the health units and the need for improvement in terms of information and support for users of oral health services.

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Rational use of medicines: contribution to development of healthcare systems

Kazan medical journal ◽

10.17816/kmj1715 ◽

2012 ◽

Vol 93 (5) ◽

pp. 803-806 ◽

Cited By ~ 1

Author(s):

L Y Shaydullina ◽

L E Ziganshina

Keyword(s):

World Health Organization ◽

Russian Federation ◽

National Level ◽

Essential Medicines ◽

World Health ◽

Prescribing Practices ◽

Rational Use ◽

Rational Use Of Medicines ◽

The Russian Federation ◽

Health Organization

Development of World Health Organization (WHO) Rational Use of Medicines concept internationally and its implementation in the Russian Federation is reviewed. The need to consolidate efforts for the introduction of the WHO-developed strategy for the use of medicines improvement is explained. The WHO strategy to improve the use of medicines is described. Abundance of medicines, medicinal products and various formulations of the same active substances, as well as of promotional materials, which often mislead healthcare community and consumers, requires establishment of a system promoting effective and safe use of medicines and ensuring access to essential medicines of all members of the society. The factors which contribute to irrational use of medicines, avoidable causes, and consequences of irrational use of medicines are presented. Current situation in the Russian Federation regarding the use of medicines: legal and regulatory framework, the results of the registration process, documents valid on a national level and in particular regions that determine pharmaceutical policy is described in detail. Methodology of assessing prescribing practices and medicine consumption recommended by the World Health Organization for implementation and use globally is revealed. The implementation of the WHO concept of the rational use of medicines in the Republic of Tatarstan is described as an example. An illustration of the authors’ findings on effects of clinical pharmacology services on containment of medicines’ costs at the level of internal diseases department of municipal hospital is presented. The leading thesis of WHO Rational Use of Medicines concept - the establishment of independent multidisciplinary regional structures responsible for the quality use of medicines - is substantiated.

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The who concept of essential medicines and the who ethical criteria for medicinal drug promotion: history and lessons for domestic pharmaceutical sector

Kazan medical journal ◽

10.17816/kmj1779 ◽

2013 ◽

Vol 94 (1) ◽

pp. 95-100

Author(s):

L E Ziganshina ◽

R R Niyazov ◽

A U Ziganshin

Keyword(s):

Health System ◽

National Level ◽

National Health System ◽

Essential Medicines ◽

Rational Use ◽

Rational Use Of Medicines ◽

Drug Promotion ◽

History Of ◽

Ethical Criteria ◽

Medicinal Drug

The review covers the history and evolution of the WHO initiatives in pharmaceutical policy - for better and safer use of medicines, their scientifically based selection and ethical promotion. The WHO Concept of Essential Medicines, the WHO vision of the Rational Use of medicines and the WHO Ethical Criteria for Medicinal Drug Promotion are reviewed. Contribution of these WHO designed initiatives, definitions and documents to Global Health, particularly relating to modern Russian health system problems is discussed. The principles and methodology of drug selection are presented. The review describes health system benefits of the WHO Essential Medicines Concept implementation at a national level. Advantages of the WHO Model List of Essential Medicines use not only as a model product, but as a model process and an healthcare instrument are emphasized. The WHO principles of the Rational Use of Medicines, the history of its International development, the WHO key strategies towards the Rational Use of Medicines and the major barriers on the way are described. The history of the WHO Ethical Criteria for medicinal drug promotion development is presented in line with the basic principles and objectives of this unique international document. The core goal of the WHO Ethical Criteria is to improve health and healthcare through the rational use of medicines. The global implementation of the WHO Essential Medicines Concept and the ever growing barriers to the rational use of medicines and advances in public health, as well the advances and problems of the Russian national health system, are discussed in the historical perspective.

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Knowledge, attitude and practices of rational use of medicines among interns in a tertiary care teaching hospital in Telangana

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i6.33939 ◽

2021 ◽

Vol 12 (6) ◽

pp. 65-69

Author(s):

Kranti Tekulapally

Keyword(s):

Teaching Hospital ◽

Tertiary Care ◽

Essential Medicines ◽

Prescribing Practices ◽

Cross Sectional ◽

Rational Use ◽

Tertiary Care Teaching Hospital ◽

Care Teaching ◽

Rational Use Of Medicines ◽

Prescription Writing

Background: Rational use of drugs significantly impacts the treatment outcomes and the cost of health care. Most of the medical students are exposed to rational use of medicines and prescription writing during their second year but it is only during internship that they actually start prescribing under expert guidance. Aims and Objective: This study was planned to assess the rational prescribing practices of Interns in a tertiary care teaching hospital. Materials and Methods: With prior approval from Institutional Ethics Committee, a cross sectional study was conducted among 2014 batch of Interns from Malla Reddy Medical College for Women, Suraram, Hyderabad. Hard copies of prevalidated questionnaire consisting of 23 questions including a question on writing a prescription for a patient suffering from cold and fever was administered to the students after taking oral informed consent. Data from completed questionnaires was entered into excel sheet and analysed using descriptive statistics. Results: Of 64 interns, only 20% were aware of the term rational use of medicines, 75% of the term essential medicines and 22% of p drugs. Most of them were unaware of the step criteria for p drugs and advantages of using p drugs (87%). 95% of them reiterated that they could label the parts of prescription but mean score of the interns for writing a prescription was 3. 62% of them had positive attitude towards prescription writing. Conclusion: There is a need to improve the knowledge, attitude and practices of Rational use of Medicinesamong the Interns. Educational interventional strategies in the form of seminars, workshops, orientation programs can be adopted to promote rational use of medicines.

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Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-017966 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017966 ◽

Cited By ~ 9

Author(s):

Maria Elizete A Araujo ◽

Marcus T Silva ◽

Tais F Galvao ◽

Mauricio G Pereira

Keyword(s):

Health Services ◽

Associated Factors ◽

Prevalence Ratio ◽

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Metropolitan Region ◽

Medical Attention ◽

Cross Sectional ◽

Physician Visits

ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil.Participants4001 adults ≥18 years of age.Primary outcomes measuresPhysician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling.Results4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors.ConclusionWhile more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.

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Perceived discrimination in health services and associated factors in Manaus Metropolitan Region, Brazil: a cross-sectional population-based study

Ethnicity and Health ◽

10.1080/13557858.2020.1817341 ◽

2020 ◽

pp. 1-11

Author(s):

Tais Freire Galvao ◽

Gustavo Magno Baldin Tiguman ◽

Bruno Vianei Real Antonio ◽

Raquel Rodrigues Ferreira Rocha de Alencar ◽

Leila Posenato Garcia ◽

...

Keyword(s):

Health Services ◽

Associated Factors ◽

Perceived Discrimination ◽

Population Based ◽

Metropolitan Region ◽

Cross Sectional ◽

Population Based Study

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Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040605 ◽

2019 ◽

Vol 16 (4) ◽

pp. 605 ◽

Cited By ~ 4

Author(s):

Karen Bissell ◽

Philippa Ellwood ◽

Eamon Ellwood ◽

Chen-Yuan Chiang ◽

Guy Marks ◽

...

Keyword(s):

Inhaled Corticosteroids ◽

Communicable Disease ◽

Action Plan ◽

National Level ◽

Essential Medicines ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Poor Access

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system’s capacity to address NCDs.

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