rational drug use
TRANSCRIPT
M.A.M.College of Pharmacy 1
RATIONAL DRUG USE ROLE OF PHARMACIST
Submitted to:V.Rajini M.Pharm
Submitted by:K.LikhitaY13PHD1111
M.A.M.College of Pharmacy 2
Contents
• Definition of RDU• Factors that raised the RDU• Factors influencing use of medicines• Types of irrational use
Diagnosis Prescription Dispensing
• Hazards of irrational use of drugs• Role of pharmacist in RDU• Methods for development of RDU
Drug use indicators Drug and therapeutics committee Standard treatment guidelines Pharmacovigilance Pharmaceutical care
• Reference
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The rational use of drugs requires that: patients receive medications appropriate to their
clinical needs in doses that meet their own individual
requirements for an adequate period of time, and at the lowest cost to them and their community.
WHO conference of experts, Nairobi 1985
DEFINITION OF RDU
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FACTORS THAT RAISED THE RDU
Drug explosion Efforts to prevent the development of resistance Growing awareness Increased cost of the treatment Consumer protection act (CPA)
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FACTORS INFLUENCING USE OF MEDICINES
RATIONAL DRUG USE
Policy, Legal and Regulatory
framework
Patient & community
Drug Supply System
Prescriber, Dispenser &
their workplaces
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TYPES OF IRRATIONAL USE
DIAGNOSIS
PRESCRIPTION
DISPENSING
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DIAGNOSIS- IRRATIONAL USE
Inadequate examination of patient
Incomplete communication between patient and doctor
Lack of documented medical history
Inadequate laboratory Resources
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PRESCRIPTION- IRRATIONAL USE
Under-prescribing
Incorrect prescribing
Extravagant prescribing
Over-prescribing
Multiple prescribing
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DISPENSING- IRRATIONAL USE
Incorrect interpretation of the prescription
Retrieval of wrong ingredients
Inaccurate counting, compounding, or pouring
Inadequate labeling
Unsanitary procedures
Packaging: Poor-quality packaging materials
Odd package size, which may require repackaging
Unappealing package
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HAZARDS OF IRRATIONAL USE OF DRUGS
Ineffective & unsafe treatment
Exacerbation or prolongation of illness.
Distress & harm to patient
Increase the cost of treatment
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ROLE OF PHARMACISTIN
RDU
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METHODS FOR DEVELOPMENT OF RDU
Drug use indicators
- prescribing indicators
- patient care indicators
- facility indicators
Drug and Therapeutics Committee
Standard Treatment Guidelines
Pharmacovigilance
Pharmaceutical care
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DRUG USE INDICATORS
• used as measures of performance in three general areas
related to the rational use of drugs in primary care:
- Prescribing practices
- Patient care
- Facility specific factors
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DRUG USE INDICATORS Continued
Prescribing indicators
1. Average number of drugs per encounter
2. Percentage of drugs prescribed by generic name
3. Percentage of encounters with an antibiotic prescribed
4. Percentage of encounters with an injection prescribed
5. Percentage of drugs prescribed from essential drugs list
or formulary
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DRUG USE INDICATORS Continued
Patient care indicators
6. Average consultation time
7. Average dispensing time
8. Percentage of drugs actually dispensed
9. Percentage of drugs adequately labelled
10. Patients' knowledge of correct dosage
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DRUG USE INDICATORS Continued
Facility indicators
11. Availability of copy of essential drugs list or formulary
12. Availability of key drugs
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DRUG AND THERAPEUTICS COMMITTEE
* providing advice on all aspects of drug management
• developing drug policies
• evaluating and selecting drugs for the formulary list
• developing (or adapting) and implementing STGs
• assessing drug use to identify problems
• conducting interventions to improve drug use
• managing adverse drug reactions and medication errors
• informing all staff members about drug use issues,
policies and decisions.
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SUCCESS OF DTC
A multidisciplinary approach sensitive to local politics
Transparency and commitment to good service
Technical competency
Administrative support
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STANDARD TREATMENTGUIDELINES
STGs may be defined as ‘systematically developed
statements to help practitioners or prescribers make
decisions about appropriate treatments for specific clinical
conditions.
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USES OF STGs
• providing guidance to health professionals on the diagnosis
and treatment of specific clinical conditions
• orienting new staff about accepted norms in treatment
• providing prescribers with justification for prescribing
decisions made in accordance with STGs
• providing a reference point by which to judge the quality of
prescribing
• aiding efficient estimation of drug needs and setting
priorities for procuring and stocking drugs.
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PHARMACOVIGILANCE
• Relating to the collection, detection, assessment,
monitoring, and prevention of adverse effects with
pharmaceutical products.
• The 4 elements of an AE case are
(1) an identifiable patient,
(2) an identifiable reporter,
(3) a suspect drug, and
(4) an adverse event.
Its study is necessary to prevent ADR to promote RDU.
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PHARMACEUTICAL CARE
Definition
The mission of the pharmacist is to provide pharmaceutical
care. Pharmaceutical care is the direct, responsible
provision of medication-related care for the purpose of
achieving definite outcomes that improve a patient’s
quality of life.
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Reference
• The rational use of drugs, Report on the conference of experts Nairobi, 25-29 Nov.1985 sponsored by W.H.O. Geneva.
• RATIONAL DRUG USE by Dr Sneha Ambwani* Dr A K Mathur **, Health Administrator Vol : XIX Number 1: 5-7
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