Rational and Irrational Drug Use: Factors, Impacts and Strategies to Combat Irrational Drug Use: A Narrative Review

2021 ◽  
Vol 2 (1) ◽  
pp. 6-17
Author(s):  
Zahra Hassan AL Qamariat ◽  
Keyword(s):  
Drug Use ◽  
Health System ◽  
Essential Medicines ◽  
World Health ◽  
Local Health ◽  
Rational Drug Use ◽  
Inappropriate Use ◽  
Rational Drug ◽  
The World ◽  
Health Organization

Misuse of drugs is a serious health problem all around the world. Rational drug use can be characterized as follows: patients receive drugs that meet their clinical needs, at doses that meet their requirements, promptly and at the lowest cost to themselves and their region. Drug abuse, polypharmacy, and misuse are the most prominent drug use problems today. Misuse of drugs can occur for a variety of reasons at different levels, including recommended mistakes and over-the- counter medications. Inappropriate use of income can lead to real negative benefits and financial results. There are many irrational drug mixtures available. Appropriate rational use of medicines will increase personal satisfaction and lead to better local health services. A list of essential medicines recommended by the World Health Organization (WHO) can assist the countries around the globe in rationalizing the distribution and purchasing of medicines, thus decreasing the costs to healthcare systems. Irrational drug use has been a subject of concern for years as it affects the health system and patients badly. Irrational use of drugs can result from several factors such as patient, prescriber, dispenser, health system, supply system, or regulations. Thus, diverse strategies have been used to promote rational drug use and also to tackle irrational use. Thereby the concept of rational and irrational drug use and factors that lead to either result should be identified and monitored.

scholarly journals Prescrições em serviços de saúde mental: aspectos legais e indicadores do uso racional de medicamentos

2017 ◽  
Vol 27 (3) ◽  
pp. 25597
Author(s):  
Sarah Nascimento Silva ◽  
Marina Guimarães Lima
Keyword(s):  
Mental Health ◽  
Drug Use ◽  
Psychosocial Care ◽  
Legal Aspects ◽  
Essential Medicines ◽  
World Health ◽  
Patient Identification ◽  
Rational Drug Use ◽  
Rational Drug ◽  
Health Organization

*** Prescriptions in mental health services: legal aspects and indicators of rational drug use ***AIMS: To evaluate the legal aspects and indicators of rational drug use in prescriptions issued by mental health services.METHODS: Prescriptions dispensed by pharmacies of reference of the Psychosocial Care Centers located in the Medio Paraopeba region, Minas Gerais, Brazil, were evaluated. A semi-structured questionnaire was developed for the collection of data, including the World Health Organization prescribing indicators and the criteria for compliance of prescriptions with the Brazilian legislation.RESULTS: A total of 390 prescriptions were analyzed, and the average number of drugs in each prescription was 2.17. It was observed that 96.78% of the drugs were prescribed by their generic names and that 97.13% were on the essential medicines list of municipalities. Legal aspects of the prescriptions were met for several criteria: 99.23% of the prescriptions had the prescriber’s signature, 98.97% showed the date of issue, and 97.69% contained minimum information for the user regarding the use of the medications. None of the assessed health centers issued prescriptions with all the necessary patient data and with information about the dispensed medications, as required by law.CONCLUSIONS: The study indicated that most of the prescriptions analyzed complied with the legal requirements and that the indicators of rational medication use were satisfactory. However, information on dispensing control and records of users was incomplete, demonstrating problems with patient identification and with the traceability of dispensed medicines.

Evaluation of rational drug use based on World Health Organization prescribing indicators in a primary care center in Pamekasan East Java, Indonesia

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Eko Prasetio ◽  
Wahyu Utami ◽  
Zulhabri Othman ◽  
Ari Wardani ◽  
Abdul Rahem ◽  
...  
Keyword(s):  
Primary Care ◽  
Drug Use ◽  
World Health Organization ◽  
Care Center ◽  
World Health ◽  
Primary Care Center ◽  
Prescribing Indicators ◽  
Rational Drug Use ◽  
Rational Drug ◽  
Health Organization

AbstractBackgroundThe Government of Indonesia has put in place many interventions for rationalizing drug use at all levels of the health services including in primary care centers (puskesmas). One of the programs for the rational use of drugs at the puskesmas is the monitoring and evaluation of drug use conducted by pharmacists. The purpose of this research was to evaluate the rationality of drug use in Pamekasan puskesmas that use World Health Organization (WHO) prescribing indicators and to find the difference in the percentage of rationality of drug use between puskesmas in Pamekasan.MethodsThis study reviewed official documents considering reporting of rational drug use. The documents were obtained from the district health office or from the public domain from 2014 to 2018. Data were then collated, extracted, and presented as frequencies.ResultsThe percentage prescribed for antibiotics for acute respiratory infection (ARI) non-pneumonia was 47.27% and percentage prescribing antibiotic drugs in a non-specific diarrhea was 59.85%. The percentage prescribed for injection was 36.15%. The average number of drugs prescribed per treatment was 2.61.ConclusionsThe majority of WHO guidelines stated that prescribing indicators were not met by the puskesmas in Pamekasan, except for the parameters for the average number of drugs prescribed per consultation. This shows an alarming clarion call for the local healthcare stakeholders to improve such situations.

scholarly journals A critical comparison between the World Health Organization list of essential medicines for children and the Brazilian list of essential medicines (Rename)

2013 ◽  
Vol 89 (2) ◽  
pp. 171-178
Author(s):  
Helena Lutéscia L. Coelho ◽  
Luís Carlos Rey ◽  
Marina S.G. de Medeiros ◽  
Ronaldo A. Barbosa ◽  
Said G. da Cruz Fonseca ◽  
...  
Keyword(s):  
World Health Organization ◽  
Essential Medicines ◽  
World Health ◽  
Critical Comparison ◽  
The World ◽  
Health Organization ◽  
Medicines For Children

scholarly journals Electrochemical design of a new nanosensor based on cobalt nanoparticles, chitosan and MWCNT for the determination of daclatasvir: a hepatitis C antiviral drug

RSC Advances ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 1118-1126 ◽  
Author(s):  
Shereen M. Azab ◽  
Amany M. Fekry
Keyword(s):  
Hepatitis C ◽  
Health System ◽  
Antiviral Drug ◽  
Cobalt Nanoparticles ◽  
Essential Medicines ◽  
World Health ◽  
Spectroscopic Methods ◽  
Basic Health ◽  
The World

Daclatasvir (DAC) is listed on the World Health Organization's list of essential medicines needed in a basic health system, therefore, electrochemical and impedance spectroscopic methods are necessary.

scholarly journals Examination of WHO/INRUD Core Drug Use Indicators at Public Primary Healthcare Centers in Kisii County, Kenya

2020 ◽  
Author(s):  
Faith A. Okalebo ◽  
Eric M. Guantai ◽  
Aggrey O. Nyabuti
Keyword(s):  
Drug Use ◽  
Low Income ◽  
Primary Healthcare ◽  
Essential Medicines ◽  
World Health ◽  
Low Income Countries ◽  
Rational Use ◽  
Health Organization ◽  
Consultation Time ◽  
Primary Healthcare Centers

ABSTRACTBackgroundIrrational drug use is a global problem. However, the extent of the problem is higher in low-income countries. This study set out to assess and characterize drug use at the public primary healthcare centers (PPHCCs) in a rural county in Kenya, using the World Health Organization/ International Network for the Rational Use of Drugs (WHO/INRUD) core drug use indicators methodology.MethodsTen PPHCCs were randomly selected. From each PPHCC, ninety prescriptions from October to December 2018 were sampled and data extracted. Three-hundred (30 per PPHCC) patients and ten (1 per PPHCC) dispensers were also observed and interviewed. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use.ResultsThe average number of drugs per prescription was 2.9 (SD 0.5) (recommended: 1.6– 1.8), percentage of drugs prescribed by generic names was 27.7% (recommended: 100%); the percentage of prescriptions with an antibiotic was 84.8% (recommended: 20.0–26.8%), and with an injection prescribed was 24.9% (recommended: 13.4–24.1%). The percentage of prescribed drugs from the Kenya Essential Medicines List was 96.7% (recommended: 100%). The average consultation time was 4.1 min (SD 1.7) (recommended: ≥10 min), the average dispensing time was 131.5 sec (SD 41.5) (recommended: ≥90 sec), the percentage of drugs actually dispensed was 76.3% (recommended: 100%), the percentage of drugs adequately labeled was 22.6% (recommended: 100%) and percentage of patients with correct knowledge of dispensed drugs was 54.7% (recommended: 100%). Only 20% of the PPHCCs had a copy of KEML available, and 80% of the selected essential drugs assessed were available.ConclusionThe survey shows irrational drug use practices, particularly polypharmacy, non-generic prescribing, overuse of antibiotics, short consultation time and inadequacy of drug labeling. Effective programs and activities promoting the rational use of drugs are the key interventions suggested at all the health facilities.

Persisting pain in childhood medical illness

2013 ◽  
pp. 319-327
Author(s):  
Martha Mherekumombe ◽  
John J. Collins
Keyword(s):  
Pain Management ◽  
World Health Organization ◽  
Essential Medicines ◽  
World Health ◽  
Medical Illness ◽  
Global Problem ◽  
The World ◽  
Health Organization ◽  
Medicines For Children

Persisting pain in the context of medical illness has been recognized recently as a global problem by the World Health Organization (WHO, 2012). Whilst the epidemiology of medical illness varies throughout the world, the general principles of pain management are applicable to most medical illnesses in children and are effective. Successful pain management for most children is contingent on the availability of the WHO model list of essential medicines for children (WHO, 2011), although regrettably not all medicines are available in every country in the world.

scholarly journals World Health Organization Essential Medicines List: Multiple sclerosis disease-modifying therapies application

2020 ◽  
Vol 26 (2) ◽  
pp. 153-158
Author(s):  
Jennifer McDonell ◽  
Kathleen Costello ◽  
Joanna Laurson-Doube ◽  
Nick Rijke ◽  
Gavin Giovannoni ◽  
...  
Keyword(s):  
Public Health ◽  
Multiple Sclerosis ◽  
Essential Medicines ◽  
World Health ◽  
Public Health Burden ◽  
Health Burden ◽  
Disease Modifying Therapies ◽  
The World ◽  
Disease Modifying ◽  
Health Organization

Introduction: The World Health Organization (WHO) publishes a biennial Essential Medicines List (EML) to assist governments in low-resource settings to prioritize their spending on medicines. Currently, no medicines on the EML have a multiple sclerosis (MS) indication. Multiple Sclerosis International Federation (MSIF) prepared an application for inclusion of MS disease-modifying therapies (DMTs) for the 2019 EML together with the regional Committees for Treatment and Research in Multiple Sclerosis (TRIMS) and the World Federation of Neurology. Rationale: The MSIF taskforce categorized 15 DMTs according to their efficacy and risk profiles to ensure the ability to treat as many different clinical scenarios as possible. Three DMTs were selected: glatiramer acetate, fingolimod, and ocrelizumab. Outcome: The WHO Expert Committee did not recommend the addition of any of the DMTs to the EML. They acknowledged the public health burden of MS, the need for effective and affordable MS medications, and the high volume of letters received in support of the application but requested a revised application. Discussion: Despite the negative outcome, the repeated recognition of MS as a global public health burden is sending a powerful message to governments globally that a range of affordable and good quality medications need to be available to health systems and people affected by MS.

Evaluating current practices and policies in the use of injectable medicines for treating myalgia in a primary care center in Pamekasan, Indonesia

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Eko Prasetio ◽  
Wahyu Utami ◽  
Zulhabri Othman ◽  
Ari Wardani ◽  
Abdul Rahem ◽  
...  
Keyword(s):  
Primary Care ◽  
Drug Use ◽  
Average Rate ◽  
Care Center ◽  
World Health ◽  
Primary Care Center ◽  
Medicine Use ◽  
Rational Drug Use ◽  
Rational Drug ◽  
Recommended Level

AbstractBackgroundMyalgia in patients can be associated with a large array of conditions, including injuries, infections and inflammations. Treatment for myalgia may include the use of oral, topical and injectable medicines (IM). However, the use of IM has been restricted by the World Health Organization due to the common hazards associated with inappropriate medicine use, risks of disease transmission and more expensive spending for using IM. Accordingly, the Ministry of Health of Indonesia (MoH) has limited the use at the level of ≤1% in every primary care center (Puskesmas) across the nation. The aim of this study was to report and evaluate rational drug use injection in myalgia in a Puskesmas in Pamekasan, Indonesia.MethodsThis study reviewed official documents, such as rational drug use report, medicine use databases and drug request report. The documents were obtained from the district health office or public domain from 2014 to 2018. Data were then collated, extracted and presented as frequencies.ResultsThe average rate of use of IM for myalgia in Pamekasan was 36.15%. All 20 Puskesmas in Pamekasan conducted injection practice above the recommended level, thus reflecting a major gap between practice and policy implementation. This study implies that a substantial effort is needed to enforce the policy.ConclusionsThe use of IM for myalgia treatment in Pamekasan from 2014 to 2018 was significantly higher than the recommended level, thus reflecting a major problem in the practice. This is an alarming call for the local healthcare stakeholders to improve such a situation.

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