Irrational Use of Medicines—A Summary of Key Concepts

Abstract

Medicines play an integral part of healthcare delivery. However, they are expensive commodities and account for a significant proportion of overall health expenditure in most countries. Irrational use of medicines is a major challenge facing many health systems across the world. Such practices are likely to lead to poor health delivery that may put patients at risk and result in wastage of scarce resources that could have been used to tackle other pressing health needs. The concept of “rational use of medicine” can at times be confusing and not easily appreciated by patients, healthcare providers, policy makers, or the public, all of whom need to collaborate effectively to address this challenge. In this article, we summarize basic concepts such as rational medicine use, good prescribing and dispensing, and explore some of the factors that contribute to irrational use of medicines as well as potential impacts of such practices. This article has been written with the intention of offering a clear, concise, and easy to understand explanation of basic medicine use concepts for health professionals, patients, policy makers, and the public.

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

“…This is because typically there are different practices, cultural beliefs as well as greater availability of healthcare professionals in higher income countries. In addition in LMICs, the costs of medicines can account for up to 70% of total healthcare expenditure, much of which is out of pocket [173][174][175] . This is again very different to high income countries where typically expenditure on pharmaceuticals is 15% or less of total healthcare expenditure and there is often universal healthcare 176,177 .…”

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study

“…Among which, the core drug use indicators have been considered as the first line indicators validated by WHO for measurement of drug use. The core drug use indicators are more informative, more feasible, less likely to fluctuate over time and place as well as easier to measure drug use than the complementary indicators [4, 5]. Therefore, the core indicators have been selected for better quantitative evaluation of RDU.…”

“…However, irrational use of drugs has been primarily observed in healthcare systems of developing countries. WHO estimates that more than half of all drugs are irrationally prescribed or dispensed and more than half of the patients fail to adhere the prescribed regimens [5]. Common reasons for irrational use of medicines include:- lack of adequate information about the prescribed drugs, faulty and inadequate training of medical graduates, poor communication between health care providers and patients, lack of diagnostic facilities, demand from the patient (assuming that ‘every ill has a pill’), and defective drug supply system [9].…”

Out-based medical education - A brief commentary

“…[25,26] Although globally there is urgent demand for the improvement in regard to rational prescribing and rectifying irrational prescribing. [27][28][29][30] Thereafter, a number of studies reported that mediations short training course and workshop targeting to improve the quality of prescription. [26,31] Qualitative content analysis revealed that outcome-based continuing medical education (CME) among general physicians (GPs) in Iran effective in improving GPs' competence toward rational prescribing.…”