Why should we insist on rational use of medicines?ย Because we ought to ensure that our patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them.
Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards.
In clinical practice we daily encounter irrational use of medicines: use of too many medicines per patient (“poly-pharmacy”); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medication, often of prescription-only medicines; non-adherence to dosing regimens.
How best can we ensure that we fulfil peopleโs needs? First, we need to develop a national list of essential drugs. Second, we must ensure that public has access to essential medicines. Third, we need to ensure that medicines procurement and supply systems are efficient and reliable to support the responsible use of medicines. Fourth, we must ensure the quality, safety and effectiveness of essential medicines at an affordable price. Fifth, we should facilitate the implementation of Evidence-based treatment guidelines. Sixth, we should put patients at the center of treatment to maximize adherence to therapy.
On 24 May 2018, I spoke on the rational use of medicines at a seminar organised by Chhaya Pachauli at Bhubaneshwar. My colleagues Dr Narendra Gupta and Chinu Srinivasan also spoke with me.
