M.A.M.College of Pharmacy 1

RATIONAL DRUG USE ROLE OF PHARMACIST

Submitted to:V.Rajini M.Pharm

Submitted by:K.LikhitaY13PHD1111

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Contents

• Definition of RDU• Factors that raised the RDU• Factors influencing use of medicines• Types of irrational use

Diagnosis Prescription Dispensing

• Hazards of irrational use of drugs• Role of pharmacist in RDU• Methods for development of RDU

Drug use indicators Drug and therapeutics committee Standard treatment guidelines Pharmacovigilance Pharmaceutical care

• Reference

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The rational use of drugs requires that: 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 and their community.

WHO conference of experts, Nairobi 1985

DEFINITION OF RDU

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FACTORS THAT RAISED THE RDU

Drug explosion Efforts to prevent the development of resistance Growing awareness Increased cost of the treatment Consumer protection act (CPA)

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FACTORS INFLUENCING USE OF MEDICINES

RATIONAL DRUG USE

Policy, Legal and Regulatory

framework

Patient & community

Drug Supply System

Prescriber, Dispenser &

their workplaces

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TYPES OF IRRATIONAL USE

DIAGNOSIS

PRESCRIPTION

DISPENSING

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DIAGNOSIS- IRRATIONAL USE

Inadequate examination of patient

Incomplete communication between patient and doctor

Lack of documented medical history

Inadequate laboratory Resources

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PRESCRIPTION- IRRATIONAL USE

Under-prescribing

Incorrect prescribing

Extravagant prescribing

Over-prescribing

Multiple prescribing

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DISPENSING- IRRATIONAL USE

Incorrect interpretation of the prescription

Retrieval of wrong ingredients

Inaccurate counting, compounding, or pouring

Inadequate labeling

Unsanitary procedures

Packaging: Poor-quality packaging materials

Odd package size, which may require repackaging

Unappealing package

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HAZARDS OF IRRATIONAL USE OF DRUGS

Ineffective & unsafe treatment

Exacerbation or prolongation of illness.

Distress & harm to patient

Increase the cost of treatment

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ROLE OF PHARMACISTIN

RDU

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METHODS FOR DEVELOPMENT OF RDU

Drug use indicators

- prescribing indicators

- patient care indicators

- facility indicators

Drug and Therapeutics Committee

Standard Treatment Guidelines

Pharmacovigilance

Pharmaceutical care

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DRUG USE INDICATORS

• used as measures of performance in three general areas

related to the rational use of drugs in primary care:

- Prescribing practices

- Patient care

- Facility specific factors

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DRUG USE INDICATORS Continued

Prescribing indicators

1. Average number of drugs per encounter

2. Percentage of drugs prescribed by generic name

3. Percentage of encounters with an antibiotic prescribed

4. Percentage of encounters with an injection prescribed

5. Percentage of drugs prescribed from essential drugs list

or formulary

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DRUG USE INDICATORS Continued

Patient care indicators

6. Average consultation time

7. Average dispensing time

8. Percentage of drugs actually dispensed

9. Percentage of drugs adequately labelled

10. Patients' knowledge of correct dosage

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DRUG USE INDICATORS Continued

Facility indicators

11. Availability of copy of essential drugs list or formulary

12. Availability of key drugs

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DRUG AND THERAPEUTICS COMMITTEE

* providing advice on all aspects of drug management

• developing drug policies

• evaluating and selecting drugs for the formulary list

• developing (or adapting) and implementing STGs

• assessing drug use to identify problems

• conducting interventions to improve drug use

• managing adverse drug reactions and medication errors

• informing all staff members about drug use issues,

policies and decisions.

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SUCCESS OF DTC

A multidisciplinary approach sensitive to local politics

Transparency and commitment to good service

Technical competency

Administrative support

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STANDARD TREATMENTGUIDELINES

STGs may be defined as ‘systematically developed

statements to help practitioners or prescribers make

decisions about appropriate treatments for specific clinical

conditions.

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USES OF STGs

• providing guidance to health professionals on the diagnosis

and treatment of specific clinical conditions

• orienting new staff about accepted norms in treatment

• providing prescribers with justification for prescribing

decisions made in accordance with STGs

• providing a reference point by which to judge the quality of

prescribing

• aiding efficient estimation of drug needs and setting

priorities for procuring and stocking drugs.

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PHARMACOVIGILANCE

•  Relating to the collection, detection, assessment,

monitoring, and prevention of adverse effects with

pharmaceutical products.

• The 4 elements of an AE case are

(1) an identifiable patient,

(2) an identifiable reporter,

(3) a suspect drug, and

(4) an adverse event.

Its study is necessary to prevent ADR to promote RDU.

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PHARMACEUTICAL CARE

Definition

The mission of the pharmacist is to provide pharmaceutical

care. Pharmaceutical care is the direct, responsible

provision of medication-related care for the purpose of

achieving definite outcomes that improve a patient’s

quality of life.

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Reference

• The rational use of drugs, Report on the conference of experts Nairobi, 25-29 Nov.1985 sponsored by W.H.O. Geneva.

• RATIONAL DRUG USE by Dr Sneha Ambwani* Dr A K Mathur **, Health Administrator Vol : XIX Number 1: 5-7

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