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Promoting Rational Drug Use in the Community

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					     Promoting Rational Drug Use
          in the Community

Prioritising Community Drug Use Problems
         Session objectives

        Develop
         Overview of most common categories
          of problems concerning drug use by
          consumers
         Insight into methods and relevant
          criteria that can be used to prioritise
          problems


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Promoting Rational Drug Use in the Community   WHO
         Common forms of inappropriate use

        1) Not using the drug in the way intended
          by the prescribing doctor
         not knowing or forgetting all or part of the
          recommendations
         insufficient motivation
         poverty no access or other external
          constraints
         those who have a change of mind or decide not
          to follow the recommendations.
              (adherence concordance compliance - discuss)

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Promoting Rational Drug Use in the Community     WHO
         Common forms of inappropriate use

        2) Self-medication with prescription drugs
        from a variety of sources
         regular pharmacies
         grocery stores and markets
         from traditional healers
         from friends and family
         old drugs
         internet sales


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Promoting Rational Drug Use in the Community   WHO
         Common forms of inappropriate use
        3) Misuse of antibiotics
         over-prescription/ over-use
              – eg for simple diarrhoea, coughs and colds
         use of unnecessarily complex drugs
         sub-optimal dose
              – drugs too expensive for full course
              – user not aware of how and how long to take

              Other categories commonly misused –
               antimalarials psychotropics


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Promoting Rational Drug Use in the Community    WHO
         Common forms of inappropriate use
         4) Misuse of injections
          over-use because
            – perception of greater effectiveness
            – higher fee for health provider
          un-safe use because
            – re-use of syringes in facilities
            – poor sterilisation
            – use of patients own syringes
          consequences
            – costs to health services
            – unnecessary risks

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Promoting Rational Drug Use in the Community   WHO
         Common forms of inappropriate use

        5) Overuse of relatively safe drugs
        common categories include
         vitamins
         analgesics
         tonics
         antidiarrhoeals (for adults)




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Promoting Rational Drug Use in the Community   WHO
         Common forms of inappropriate use

        6) unsafe use of herbal and traditional
          medicines.

        7) use of inessential combination drugs

        8) use of needlessly expensive drugs




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Promoting Rational Drug Use in the Community   WHO
         Prioritising

        1 Identify major problems
        2 Analyse the problems and identify the
          key reasons why they are problems
        3 From the key reasons identify criteria
          for priority setting
        4 Select key criteria
        5 Rank/rate problems using criteria
        6 Discuss and evaluate results


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Promoting Rational Drug Use in the Community   WHO
         Prioritising - possible criteria

            scale of the problem
            seriousness of the adverse effects
            economic cost
            appropriateness for intervention
            …..
            …..




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Promoting Rational Drug Use in the Community   WHO
         Rating looks at each problem
         separately
                               Antibiotic
                               misuse
        
        Health       3
        consequences

        Economic               3
        costs

        Affects                1
        whole
        communities


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Promoting Rational Drug Use in the Community   WHO
         Ranking compares problems against
         criteria
                                    Antibiotic   Misuse         Analgesic
                                   misuse       Injections     overuse

            Health       2                       3              1
            consequences

            Waste of
            money

            Affects
            whole
            communities

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Promoting Rational Drug Use in the Community                  WHO
         Enhancing stakeholder participation

         What is the community perception
         Need to identify, understand and
          respect different perspectives on a
          problem
         Helps to ensure appropriate, “owned” and
          effective analyses and interventions

         Different methods can be used to
          enhance stakeholder intervention

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Promoting Rational Drug Use in the Community   WHO
         Prioritising community drug use problems
         Unpick the problems – for whom is it a
          problem? What are the consequences and
          who is most affected? How does it
          relate to other problems?
         Be selective – you may need to prioritise
          which problems you have the time and
          resources to address
         You can use different criteria and tools
          to prioritise
         Stakeholder involvement important for
          success

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Promoting Rational Drug Use in the Community   WHO

				
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