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GROUP 5 PRESENTATION

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GROUP MEMBERS• MATHEWS MUSOWA :Bpharm 14/01/002019• ITAVELENI NAUKUSHU :Bpharm 14/01/002199• BELLO KALWAKU :Bpharm 14/01/002170• ALBERT CHITESHE :Bpharm 14/01/001808• MILUMBE KATOWA :Bpharm 14/01/002180

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OBJECTIVES• Define rational use of medicines and identify the magnitude of the

problem

• Understand the reasons and factors underlying irrational use of drugs.

• Discuss the impact of irrational drug use

• Discuss strategies and interventions to promote rational use of medicines

• Discuss the role of government, NGOs, donors and WHO in solving drug use problems

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WHAT IS RATIONAL DRUG USE:

• 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.

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WHAT IS A DRUG, MEDICICE AND WHAT IS THE DIFFERENCE?

A drug- is any substance other than food, that when inhaled, injected, smoked, consumed, absorbed via a patch on the skin or dissolved under the tongue causes a physiological change in the body and is a substance that is often considered narcotic, hallucinogen or a stimulant.A medicine- is any substance that is designed to prevent or treat diseases.

Difference• Drugs can cause stupefaction.• Medicine does not cause stupefaction.• Addiction to drugs can be harmful.• Medicine do not cause addiction.

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THIS CONSISTS OF:• correct drug• appropriate indication• appropriate drug considering

efficacy, safety, suitability for the patient, and cost

• appropriate dosage, administration, duration

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Cont:

• no contraindications

• correct dispensing, including

appropriate information for

patients

• patient adherence to treatment.

FACTORS AND REASONS THAT INFLUENCE USE OF MEDICINES.

Treatment Choices

Prior Knowledge

HabitsScientific Information

RelationshipsWith Peers

Influenceof DrugIndustry

Workload & Staffing

Infra-structure

Authority & Supervision

Societal

Information

Intrinsic

Workplace

Workgroup

Social &CulturalFactors

Economic &Legal Factors

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REASONS• Lack of information• Faulty & inadequate training & education of medical

graduates• Poor communication between health professional &

patient• Lack of diagnostic facilities/Uncertainty of diagnosis• Demand from the patient• Defective drug supply system & ineffective drug

regulation• Promotional activities of pharmaceutical industries

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DRUG PURCHASES THROUGH THE PRIVATE SECTOR

50-90% of all drug purchases are private-25% to 75% illness episodes self-medicated-1/2 consumers buy 1-day supply at a time

-50% of people worldwide fail to take drugs correctly

Results not always therapeutic-Over-treatment of mild illness-Inadequate treatment of serious illness-Mis-use of anti-infective drugs-Over-use of injections

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IMPACT OF IRRATIONAL USE OF DRUGS

• Adverse, possibly lethal effects• Limited efficacy• Antibiotic resistance• Drug dependence• Risk of infection • Waste of resources

MALARIACHOROQUINE RESISTANCE IN 81/92 COUNTRIESTUBERCULOSIS2 - 40 % PRIMARY MULTI-DRUG RESISTANCEGONORRHEA 5 - 98 % PENICILLIN RESISTANCE IN N. GONORRHOEAEPNEUMONIA AND BACTERIAL MENINGITIS 12 - 55 % PENICILLIN RESISTANCE IN S. PNEUMONIAE

OVER USE AND MIS-USE OF ANTIMICROBIALS CONTRIBUTES TO ANTIMICROBIAL RESISTANCE.

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Economic: Offer incentives

– Institutions– Providers and patients

Managerial: Guide clinical practice

– Information systems/STGs

– Drug supply / lab capacity

Regulatory: Restrict choices

– Market or practice controls

– Enforcement

Educational: Inform or persuade

– Health providers– Consumers

Use of Medicines

STRATEGIES TO IMPROVE USE OF DRUGS

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WHY DOES IRRATIONAL USE CONTINUE?

Very few countries regularly monitor drug use & implement effective nation-wide interventions - because…

• they have insufficient funds or personnel.• they lack awareness about the funds wasted

through irrational use.• there is insufficient knowledge of concerning

the cost-effectiveness of interventions.

Choosing an Intervention• A single educational strategy is often not effective and does not

have a sustainable impact.• Printed materials alone are not effective.• Combination of strategies, particularly of different types (e.g.

educational + managerial) always produces better results than a single strategy.

• Focused small groups and face to face interactive workshops have been shown to the effective.

• Audit and feedback, peer review, are very effective.• Economic strategies are very powerful strategies to change drug

use but may be difficult to introduce.

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IDENTIFYING EFFECTIVE STRATEGIES TO PROMOTE MORE RATIONAL USE OF DRUGS .

• Joint research initiative between Organisation.– It has been proven that research projects in

developing countries is effective in promoting (RUD)

• WHO database on drug use– quantitative data on drug use and interventions to

improve drug use over the last decade

1. Evidence-based standard treatment guidelines.2. Essential Drug Lists based on treatments of choice.3. Drug & Therapeutic Committees in hospitals.4. Problem-based training in pharmacotherapy in UG training.5. Continuing medical education as a licensure requirement.6. Independent drug information e.g bulletins, formularies7. Supervision, audit and feedback.8. Public education about drugs.9. Avoidance of perverse financial incentives.10. Appropriate and enforced drug regulation.

10 NATIONAL STRATEGIES TO PROMOTE RUD (needs sufficient govt. investment for medicines & staff !)

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WHO PRIORITIES• Developing a model formulary process, the WHO Essential

Drugs Library• Training programmes• Promoting drug & therapeutic committees• Pilot projects to contain antimicrobial resistance• Intervention research to promote RUD

– cost-effectiveness of interventions, policies • Advocacy for the rational use of drugs (RUD)

– Essential Drug Monitor, effective drug information.

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THANK YOU !!!!!!!!THIRD YEAR SECOND SEMESTER CLASS 2016