Social Pharmacy

Lecture no. 6 Rational use of drugs

Dr. Padma GM Rao RAK COPS

Rational Drug Use &

essential Drug Concept

Learning objectives

• Explain rational drug use with its importance• Define the term Essential Drug Concept• Some understanding on national drug policy• Common problems associated with drug use• Pharmacists role in promoting rational drug

use.• Guidelines for rational prescribing

What is rational drug Use (RDU)?

• Rational Drug Use is defined as the use of an appropriate,effecacious,cost-effective and safe drug for the right indication in the right dose, right formulation at right intervals for the right duration of time.

Advantages of RDU• Safe• Effective• Ecnomical• Used when required

Importance of rational drug use

• Affect the health of individuals and communities, health care cost and the environment.

• Irrational drug use leads to ineffective and unsafe treatment, worsening or prolonging of illness and adverse reactions.

• Inappropriate treatment also increases the cost to the patient

• Antibiotic resistance

Irrational prescribing practice

• Prescribing drugs of no proven value• Prescribing empirically• Prescribing drugs for self- limiting conditions• Overdosing and under dosing of drugs• Prescribing costly drugs• Using injectables when oral drugs are

available

Persons involved in irrational drug use

Patient Self medication

CompliancePhysicians Inadequate knowledge Financial interestPharmacist Errors in dispensing Financial interest

• Manufactures

Financial interest Misleading information by medical representatives

Reasons for irrational drug use

• Unrestricted entry of prescription drugs• Lack of drug information• Inadequate training & skills• Confusion due to brand names• Aggressive marketing strategies• Increased work load for doctors• Cost factors

Reasons contd..

• Preference to company or drugs• Attitude of people• Professional competition• Lack of diagnostic facilities• Erratic supply & shortage of drugs• Lack of essential drugs

What does RDU require?

• Adequate diagnosis• Correct prescribing of drugs• Non drug treatment• Correct dispensing• Patient’s adherence with therapy

How to promote RDU?

Entire health care team is essential to promote RDU .There are a wide range of activities to be performed to promote RDU Educational strategies

Development of clinical guidelines and essential drug list Basic training for health care professionals In service training for health workers

• Drug information centers• Consumer information & education

• Managerial strategies• Regulatory strategies to promote RDU

RDU in a hospital setting

• Drug Formulary• Drug & Therapeutic Committee(DTC/ PTC)• Drug use evaluation• Clinical pharmacists

Role of pharmacists in RDU

Pharmacists play a key role in the followingaspects of drugs• Procurement• Distribution• Dispensing• Education• Prescribing information• Pharmaceutical care

Drug procurement

• Selection of drugs should be based on• Needs of the situation• Cost-effective• Affordable & quality drugs Controlled by the Pharmacy & Therapeutic

Committee of the Hospital.

Objectives of procurement

• Procure the most cost-effective drugs in right quantities

• Select reliable suppliers of high quality drugs• Ensure timely delivery Inventory controlProper inventory control is done by monitoring

the stocks and preventing out of stock situations.

• Use of a good formulary or drug list- Restrict the no. & brand of drugs

• Drugs with overdue expiry date should not be stored / dispensed

Information & education Information about introduction of new drugs,

policy changes regarding drugs, availability of drugs and drug related problems

Role of clinical pharmacists

• Drug information• ADR monitoring and reporting• Drug therapy monitoring• More focused teaching on patient and the

disease rather than on general information on drugss

• Publication of drug bulletins• Monitoring of ADRs and reporting to the

monitoring centers in hospital, region or country.

• Education programs to create awareness regarding ADRs

• Counseling programs – appropriate drug use and patient compliance.

Pharmaceutical care

• Optimize patient’s health related quality of life and achieve positive and cost- effective clinical outcomes.

• Individualized drug therapy plan in consultation with other health care professionals and the patient

• Establish a professional relationship b/w the patient and other health care providers.

National drug policy(NDP)

• Rational drug use is an extremely important part of NDP

What is NDP ?

• The way in which the country regulates the availability, quality and use of drugs

• To improve the health of the people.