|
|
Rational use of medicines: the need of the hour. |
|---|
Rational use of medicines requires that 'patients receive medications appropriate to their clinical needs, at doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community' (as defined by WHO). Irrational use of medicines is a global problem and particularly more common in developing countries like India because of under surveillance from the regulatory agencies and less awareness among medical professionals and public in general.
It is rather unfortunate that till date there is no 'standard treatment protocol' guidelines implemented even in major tertiary health institutes of our state Tripura and consequently, uniform & standard treatment guidelines are usually not followed while prescribing. Hence, there remain scopes of irrational use of medicines by medical professionals unintentionally or in a few cases under influence of unethical promotions by drug companies. Some random examples of irrational drug use are: a) Poly-pharmacy: use of too many medicines per patient or per prescription even when it is not really necessary; b) Inappropriate use of antibiotics; c) Overuse of injections when oral preparations could have been prescribed etc. These all factors ultimately jeopardize the cost benefit ratio of the given treatment and thus put the patients under unnecessary economic strain in many cases.
All blames should not go to the doctors alone for treatment failures, serious side effects etc arising for irrational use of medicines but the patients also share their part. Many a times, self medications, non adherence to the prescribed dosing regimes and failure to take the prescribed drugs for the advised duration also increase the magnitude of the problem. In our state its often observed that many
'prescription only drugs' (those medicines which should not be sold without a prescription from a registered medical practitioners) are easily available over the counter of pharmacies, drug stores etc and often patients take them only for a short time without any advise of doctor. It may give rise to development of drug resistance in near future, can render an effective antibiotic of the day ineffective in coming days and also may be harmful to the patient. Patient demands and certain prevalent misbelieves in general public (common example many patient insists to add on a multi-vitamin syrup in the prescription when it mayn't be needed at all) also may influence prescribing pattern of a doctor. Thus the education of the patients and provision of basic health information to the public are essential components for promotion of rational use of drugs.
It is widely assumed that use of drug by a qualified doctor is rational but in reality irrationality abounds in many aspects of medicines, i.e. selection, procurement, storage, prescribing, dispensing, monitoring and feedback which may lead to inappropriate, ineffective and economically inefficient use of medicines. Irrational prescribing and poor dispensing adversely impact morbidity & mortality in general population and also leads to wastage of resources, unwanted side effects and adverse psychological suffering. Interventions to improve prescribing and dispensing practices can be educational (by conducting CME, Seminars etc) and regulatory.
Regular exposure to training program to medical practitioners and sensitization of patients regarding the rational use of medicines is the need of the hour for developing countries like India where a strong functioning pharmacovigilance system throughout the country for continuous monitoring of safety data is still on the way of making. Till the time 'Pharmacovigilance Program of India' is properly implemented all over the country, continuous education of both the medical professionals & the patients is needed to ensure safe and effective use of drugs. I would like to mention here that a process has already been initiated to form a local state chapter of the Indian Society for Rational Pharmacotherapeutics (ISRPT) in our state for promoting rational use of medicines. ISRPT (www.isrpt.co.in) comprises of prominent academicians of the premium medical institutes of India
, govt. regulatory officials & other relevant medical professionals. Under their aegis, ISRPT - Tripura State Branch has intention to conduct relevant seminars & training programs to sensitize doctors, medical students & general public of our state in near future.
Published on 06 Sep, 2010 Readers can send their comments on this feature to : feature@tripurainfo.in