# \[e-drug\] Rational versus Appropriate Medicines Use **URL:** \ **Category:** e-drug\ **Created:** [November 25, 2007, 12:43pm UTC](https://talk.edrugplus.org/t/e-drug-rational-versus-appropriate-medicines-use/28885 "2007-11-25T12:43:34Z")\ **Posts on this page:** 4\ **Page:** 1
**Author:** ![Chris\_Forshaw3](https://avatars.discourse-cdn.com/v4/letter/c/c2a13f/32.png) [@Chris\_Forshaw3](https://talk.edrugplus.org/u/Chris_Forshaw3)\ **Post date:** [November 25, 2007, 12:43pm UTC](https://talk.edrugplus.org/t/e-drug-rational-versus-appropriate-medicines-use/28885/1 "2007-11-25T12:43:34Z")
E-DRUG: Rational versus Appropriate Medicines Use -------------------------------------------- Dear E-druggers The ongoing debate on the Make Medicines Child Size slogan and the various proposed better alternatives has stimulated me to put forward a case for consideration of changing from Rational Medicines Use to Appropriate Medicines Use. According to definitions gleaned from the numerous online dictionaries available the adjective rational is associated with reasonable, sensible and logical. Thus it would be rational for a patient to only buy a single days treatment of an antibiotic rather than a full 5-day course if that was all they could afford. It would also be rational for them to stop taking a medicine if they appeared to be cured or if they experienced unpleasant adverse effects. However in these cases it would certainly not be appropriate for them to behave this way in terms of obtaining the required and expected therapeutic benefit of the medicine. On the other hand the word appropriate is associated with suitability and fitness for purpose or circumstances. This would therefore seem to be indeed much a more appropriate adjective when applied to medicines use. The word could equally well be applied to the WHO childrens medicines campaign as in \>\>\>Make Medicines Appropriate for Children\<\<\< Best regards Chris Forshaw Pharmaceutical Adviser Ministry of Health, Kenya c/o Royal Danish Embassy Box 40412-00100, Nairobi, Kenya Mobile: +254 724 253 202 Tel/fax (home): +254 20 206 2156 Office direct: +254 20 272 4944 forshaw@hsps.or.ke ---
**Author:** ![Dr\_Peter\_R\_Mansfield](https://avatars.discourse-cdn.com/v4/letter/d/c68b51/32.png) [@Dr\_Peter\_R\_Mansfield](https://talk.edrugplus.org/u/Dr_Peter_R_Mansfield)\ **Post date:** [November 26, 2007, 6:51am UTC](https://talk.edrugplus.org/t/e-drug-rational-versus-appropriate-medicines-use/28885/2 "2007-11-26T06:51:17Z")
E-DRUG: Rational versus Appropriate Medicines Use (2) -------------------------------------------- Dear E-druggers, I agree with Chris Forshaw that "appropriate" is a more appropriate word than "rational". One of my reasons is that whilst many decisions are bad, few are irrational. Usually the logic is valid but based on information that is flawed, irrelevant and/or incomplete. Another reason is that the word used can make a big difference to discussions about treatment choices that we disagree with. If we suggest that a treatment choice is irrational then we are suggesting that the person who made the choice is mentally deficient. This is not a good way to win friends and influence people! By contrast, if we suggest that a treatment choice is inappropriate then we are focusing on disagreements about aspects of the drug. The latter is more likely to be successful. This is why in 1983 I named my organisation the Medical Lobby for Appropriate Marketing. Our name has been changed to Healthy Skepticism but we still work for appropriate medicines use. regards, Peter Dr Peter R Mansfield OAM BMBS GP Director, Healthy Skepticism Inc www.healthyskepticism.org Lecturer, Discipline of General Practice, University of Adelaide www.adelaide.edu.au/directory/peter.mansfield peter.mansfield@adelaide.edu.au ---
**Author:** ![b.futter](https://avatars.discourse-cdn.com/v4/letter/b/51bf81/32.png) [@b.futter](https://talk.edrugplus.org/u/b.futter)\ **Post date:** [November 26, 2007, 7:04am UTC](https://talk.edrugplus.org/t/e-drug-rational-versus-appropriate-medicines-use/28885/3 "2007-11-26T07:04:30Z")
E-DRUG: Rational versus Appropriate Medicines Use (3) ------------------------------------------ A suggested intepretation of the differences between rational and appropriate. First point to bear in mind is that 'use' often refers to the prescriber, not just the patient. Second is the question of Standards. When standard treatment guidelines are developed based on efficacy, and clinical data, there is an assumption about a standard rational patient (i.e. generic). This is the starting point. However, people and circumstances differ. When these differences are taken into consideration, when making assumptions about patient behaviour, prescribing becomes appropriate. i.e. it becomes more cost effective. cheers, Billy Billy Futter Associate Professor Faculty of Pharmacy Rhodes University, Grahamstown, South Africa email B.Futter@ru.ac.za phone 046 603 8494 fax 046 636 1205 ---
**Author:** ![pharmacomateriovigil](https://avatars.discourse-cdn.com/v4/letter/p/2acd7d/32.png) [@pharmacomateriovigil](https://talk.edrugplus.org/u/pharmacomateriovigil)\ **Post date:** [December 7, 2007, 12:40pm UTC](https://talk.edrugplus.org/t/e-drug-rational-versus-appropriate-medicines-use/28885/4 "2007-12-07T12:40:17Z")
E-DRUG: Rational versus Appropriate Medicines Use (4) ------------------------------------------------ Appropriate or Rational Use of medicines ? Appropriate means correct or suitable, convenient, and correct means without mistake. Does the prescription of the the right medicine to the right patient at the right dose is always without mistake ? I do not think so! Rational means to do something according to the reason or to do something in one way able to reason (logical) or to persuade by a fair argument and more comprehensible mean. If you try to do something only with unbiased judgement, logically, rational is better than appropriate who is equivalent to correct, but in rational use all is not always correct. Consequently, keep rational use of medicines in your agenda. A. Helali Clinical pharmacologist Director Centre National de Pharmacovigilance et de Matériovigilance BP. 247, Bab El Oued 16009 Algiers Fone/fax : 213 21 36 36 71 CNPM \