Rational and irrational use

Pharmacy Practice

1. 1 Course 705# Pharmacy Practice : Dr. Shahana

2. 2 Rational use of medicines

3. What is RDU and its Criteria for using medicine Irrational use of drugs, Stages Essential medicines and NEML Types of irrational use and Examples Problem in Rational Drug Use Methods to promote RDU by Drug use indicators what are Guidelines Role of Pharmacist in RDU 3 CONTENT

4. Rational drug use can be defined as the usage of appropriate drug with proven safety & efficacy for the right patient in the appropriate dose and dosage form at proper intervals of time at low cost. WHO: The rational use of drugs requires that patient receive medication appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time and at lowest cost to them and their community 4 What is RDU and its Criteria

5. Appropriate indications Appropriate drug Affordable Appropriate administration, dosage and duration Appropriate patient Appropriate patient information 5 Criteria

6. It is the irrational use of DOSAGE, REGIMEN AND DURATION OF PARTICULAR AILMENT SELF MEDICATION, EASY ACCESSIBILITY OF DRUGS, RAMPANT USAGE MEDICINES BY THE PRESCRIBERS 6 Irrational use

7. Diagnosis Prescription Dispensing Patient Adherence 7 Stages of Irrational use

8. Essential medicines are regarded as those medicines that satisfy the priority health care needs of the population. The EML is a list of minimum medicine needs for a basic health-care system, focusing on the most efficacious, safe, and cost-effective medicines for priority conditions.  8 Essential medicines

9. 1994, then 2003, as per Ministry of Health Government of Pakistan Islamabad 2007 335 Medicines Essential medicines as defined by WHO are those that satisfy the health care needs of majority of the population. They should therefore be available at all times in adequate amounts and in the appropriate dosage forms.    9 National Essential medicines of Pakistan NEML

10. DIAGNOSIS 1. Inadequate examination of patient. 2. Incomplete communication between patient and doctor 3. Lack of documented medical history 4. Inadequate laboratory test 10 Types of irrational use

11. PRESCRIPTION WRITING AND REVIEWING 11 Types of irrational use

12. Factors affecting PRESCRIPTION 1. Patient factors 2. Paternalism to individualism, with patient autonomy, for instance, being considered as a fundamental principle 3. Doctor–patient interaction 12 Types of irrational use

13. 13 Types of irrational use

14. PRESCRIPTION 1. Under prescribing 2. Incorrect prescribing 3. Extravagant prescribing 4. Over prescribing 5. Multiple prescribing 14 Types of irrational use

15. DISPENSING 15 Types of irrational use

16. DISPENSING Innocent interpretation of the prescription Retrieval of wrong ingredients Inaccurate counting, compounding, or pouring Unsanitary procedures Packaging: Poor quality packaging material Odd package size, which may require repackaging Unappealing package 16 Types of irrational use

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21. Aspirin and Pain killers Antibiotics Cough preparations Sedatives and Substances for Addictions 21 Examples

22. 22 Factors contributing Rational Drug Use

23. The prescriber may obtain some financial benefits in prescribing more drugs. The chemist may also promote irrational drug use to enhance his sales Easy availability of even schedule H drugs No proper training and continues education to the prescriber There is a wrong notion among common man that every ill has a pill resulting in medication even in ailments which are self limiting 23 Problem in Rational Drug Use

24. Educational 2. Regulatory 3. Managerial Prescribing Indicators: Average number of drugs per prescription. Percentage of drugs prescribed by generic names. Percentage of time an antibiotic is prescribed. Percentage of drug prescribed from an essential drug list or formulary.s 24 Methods to promote RDU by Drug use indicators

25. Educational 2. Regulatory 3. Managerial Patient care indicator: Average consultation time. Average dispensing time. Percentage of drugs actually dispensed. Percentage of drugs adequately labelled. Patient’s knowledge of correct dosage . 25 Methods to promote RDU by Drug use indicators

26. Educational 2. Regulatory 3. Managerial Facility Indicators: Availability of copy of essential drugs list or formulary. Availability of key drugs. 26 Methods to promote RDU by Drug use indicators

27. Most important step in drug therapy is correct diagnosis. The second step is to assess whether the need of drug is genuine or not. If therapy is essential then various treatment should be considered. Next step is the selection of dose which is appropriate for the patient 27 What are Guidelines AND Role of Pharmacist in RDU

28. Patient should be clearly instructed regarding his ailment, how to consume and when to. Degree of effectiveness of the therapy should be monitored. If there is no effect by the therapy then it must be diagnosis, etc and other associated accept should be reconsidered. 28 What are Guidelines AND Role of Pharmacist in RDU

29. Ofori- Asenso , R., & Agyeman, A. A. (2016). Irrational Use of Medicines-A Summary of Key Concepts.  Pharmacy (Basel, Switzerland) ,  4 (4), 35. https://doi.org/10.3390/pharmacy4040035 World Health Organization Rational use of drugs: A review of major issues; Proceedings of the Conference of Experts; Nairobi, Kenya. 22–29 November 1985. [ Google Scholar ] [ Ref list ] 29 references