E-drug: Drug prescribing in NIS countries (cont'd)
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High usage of antibiotics and injections is one of the most common
prescribing problems in many countries. There are a number of
factors involved in these kinds of practices. There are many
mis-perceptions among patients/consumers and prescribers on the
needs and efficacy of injectable products. In addition, there is often
an excessive availability of injectables in health facilities (in some
countries also in the market).
In Indonesia we gained much experience on how to reduce overuse
of injections. We used to have a very high injection use in health
facilities (around 80% of patients received an injection). With
multiple interventions, educational and behavioural, followed by
monitoring and supervision, the use of injection was reduced to less
than 10%. Such multiple interventions were needed to sustain the
impact. Training alone may not have enough impact, since the
underlying factor is not only a lack of knowledge.
I would propose to undertake more in-depth analysis with
qualitative techniques to disclose the underlying factors of overuse
of injections. Once you identify those factors, you can plan a more
focused intervention.
Budiono Santoso
Regional Adviser Pharmaceuticals
WHO Western Pacific Regional Office
Manila, The Philippines
e-mail: santosob@wpro.who.int
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