[e-drug] How can we promote rational use of medicines?

e-drug
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E-DRUG: How can we promote rational use of medicines?
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Dear E-Druggers

We recently had a technical briefing seminar on issues concerning essential medicines in WHO Geneva. The presentations can be viewed at http://mednet2.who.int/tbs/tbs2006/tbs_programme06.htm . During the session on rational use of medicines, group work was done by the participants on how to stimulate governments, NGOs & donors, and WHO to do more to promote rational use of medicines. The output of the group work is as below.

Output of Group Work from Session on Rational Use of Medicines at the Technical Briefing Seminar, September 2006.

Introduction

The last 45 minutes of the session on rational use of medicines at the technical briefing seminar was devoted to group work where the following questions were discussed:

How can we stimulate:
* governments,
* NGOs and donors,
* WHO,
to promote the rational use of medicines?

  Results of Group Work

Stimulating governments
* Do situational analysis
* Evaluate the impact of programs in terms of medicines use, quality of service and costs
* Lobby with doctor MPs
* Involve consumers and the media
* WHO country offices to make recommendations to MOH to establish units, with sufficient resources, devoted to promoting rational use of medicines

Stimulating NGOs and donors
* Advocate benefit of rational use of medicines from public health and financial perspectives
* Include a rational use of medicines indicator in every proposal
* Involve NGOs in rational use of medicines activities
* MOH/WHO to coordinate NGOs and donors, in collaboration with civil society, with regard to activities concerning rational use of medicines
  
Stimulating WHO
* Appoint staff in every region with a specific mandate to work in collaboration with MOHs to promote rational use of medicines
* Support countries to establish a unit on rational use of medicines within the MOH
* Undertake advocacy
* Budget for activities on rational use of medicines at country-level.

We found the output of the group very interesting and would be grateful for the views of E-Druggers on these questions. The issue of rational use of medicines was discussed at the last Executive Board in May 2006 and will be discussed again in January 2007. The document on rational use of medicines can be viewed at http://www.who.int/gb/ebwha/pdf_files/EB118/B118_6-en.pdf .

Best wishes

Kathy

Dr. Kathleen Holloway,
Medical Officer for Policy, Access and Rational Use,
Department of Medicines Policy and Standards,
World Health Organisation, 20 Avenue Appia, Genève, CH-1211.
Tel: +41 22 791 2336; Fax: +41 22 791 4167
Email: hollowayk@who.int

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E-DRUG: How can we promote rational use of medicines? (2)
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dear E-druggers,

The Report by the Secretariat in Dr. Holloway's posting
(http://www.who.int/gb/ebwha/pdf_files/EB118/B118_6-en.pdf )
identifies misuse and non-use of antibiotics as a major area of
irrational use of medicines. With respect to undertaking advocacy
within WHO and other interested parties, a concerted program to focus
on a few areas of infection and appropriate antibiotic use and
non-use might make a difference in this major public health problem.
It could retard the loss of efficacy of our current antibiotics
through decreasing their improper use and improve the treatment of
common conditions such as bacterial pneumonia requiring antimicrobial
therapy. Devoting a major concerted effort on one clear subject for a
period of time might make a bigger impact than the same effort
diffused broadly throughout the field of rational use of medicines.

regards

Marcus Reidenberg
mmreid@med.cornell.edu

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E-DRUG: How can we promote rational use of medicines? (4)
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In the light of the unethical/misleading/inaccurate
promotion of medicines as a contributory factor to the
irrational use of medicines as highlighted in the
report, I would like to suggest that through
governments there should also be stimulation of health
professional associations to address this issue and
develop their own ethical guidelines addressing
interactions with the pharmaceutical industry. This
can stimulate discussion of these issues within the
professions, act as local material within universities
for training future professionals and can enhance the
application of formal legistlation to address the
issue.

Presence of such local ethical codes could be an
indirect indicator of progress towards improving
medicine use.

Regards

Douglas Ball
Faculty of Pharmacy
Kuwait University
dball@hsc.edu.kw

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E-DRUG: How can we promote rational use of medicines? (6)
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We should include rational use of drugs as subject in curriculum of medical and pharmacy schools,every pharmacist and prescribe should attend one week course every two year and it should be mandatory for renewal and issuance of practise licence and one national or international awards for best rational prescriber and pharmacist and every unethical /misleading/inaccurate ways of promotion of drugs should be discussed at every forum like pharmacy and therapeutic committee even to the public,
  
S. Khalid Saeed Bukhari
skhs60@yahoo.com

[Please remember affiliation next time. Moderator]

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E-DRUG: How can we promote rational use of medicines? (11
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As part of continuing education and upgrading of health professionals such
as pharmacists, doctors, nurses there is need to reemphasise the rational use of drugs. l also agree that courses of rational drug use should be done so that health professional keep abreast with new developments and also revatilise what they know. l think organisations like WHO should stipulate that the rational use of drugs is of utmost importance therefore it should be mandatory that such courses are done in pharmacy, medical and nursing schools.

FMudzimu
PHARMACIST
Natpharm,ZIMBABWE
fmudzimu@natpharm.co.zw or fordmdzimu@yahoo.co.uk

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E-DRUG: How can we promote rational use of medicines? (13)
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In my opinion the promotion of rational use of
medicines should be taken up from following activities
incorporated in the health systems:

1. Pharmacy and Therapeutic Committees shoiuld be
mandatory for every public sector and teaching
institution in the country.

2. Establishment & Monitoring of Rational prescribing
systems should be a compulsory part of the P &TC
objectives

3. The health systems should have systems for giving
out warnings over irrational prescribing practices and
this calls for prescription monitoring at regulatory
levels. The cases of irrational prescribing must be
reported to some instituion which hold the athority of
giving out Godd Standing certificates to prescribers

4. Patient/ Consumer awareness is last but not the
leeast is the most powerful tool for cmpelling the
prescriber to rational practices. The basic health
awareness programs for the community must include what
to expect form the treatment outcomes and could be the
possible harmful or irrational way of managing the
illness.

This is of particular importance in the common heath
problems like, Diarrhoea, Common cold, nutritional
defficiencies and irrational use of nutritional
supplement.

5. The irrational prescribing are mostly motivated by
the pharmaceutical companies. The Basic in this regrad
like ethical practices of marketting should be
essential part of medical , pharmacy & nursing
curriculas. With raging unethical trends in
pharmaceutical marketting this is of prime importance
to inculcate this pricinciples inthe minds of young
professionals.

The rational prescribing should be part of the
curricula rather then a sermon which is often
delivered once you have graduated from a medical of
pharmacy school. It should nt be an ooptional practice
which only the morlaly conciuous people shall take
account of.

Huma Nouman
Clinical Pharmacist
The CHildren's Hospital
& The Institute of Child Health
Lahore-Pakistan
leohumapk@yahoo.co.uk