NTA Level 5 • Semester 1 • PST05105

Factors Contributing to Irrational Use of Medicines

Rational Use of Medicines • Source Session/Topic 3

Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability.

Session 3: Factors Contributing to Irrational Use of Medicines

Total Session Time: 120 minutes

Prerequisites

• None

Students Learning Tasks

By the end of this session students are expected to be able to:

• Give Overview of Factors Contributing to Irrational Use of Medicines

• Identify Factors Contributing to Irrational Use of Medicines

• Explain Factors Contributing to Irrational Use of Medicines

Resources Needed:

• flip charts, marker pens, and masking tape

• black/white board and chalk/whiteboard markers

• Figure 3.2:Factors influence use of medicines

SESSION OVERVIEW

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (05 Minutes)

READ or ASK students to read the learning objectives and clarify

ASK students if they have any questions before continuing.

STEP 2: Factors Contributing to Irrational Use of Medicines (30 Minutes)

• There are many factors that contribute to the irrational prescribing or

use of medicines.

• These factors can be traced to various stages of the medicine use cycle,

and can be broadly categorized into those emanating from patients,

prescribers, workplace (health system), supply system (including industry

influences), regulation, drug information or misinformation, or a

combination of these factors.

• Uninformed patients who may have the perception that there exists a pill

for every ailment can exert undue pressure on health providers to

prescribe medicines, even when this is not needed.

STEP 3: Factors Contributing to Irrational Use of Medicines (30 Minutes)

|Activity: Brainstorming (15 Minutes) |

|Ask students to brainstorm on the following question: |

|What are the factors contributing to irrational use of medicines? |

|ALLOW few students to respond? |

|WRITE their responses on the flip chart/ board |

|CLARIFY and SUMMARISE by using the content below |

The following are the factors contributing to irrational use of medicines

• Lack of skills and knowledge.

• Inappropriate unethical promotion of drugs

• Overworked of health workers.

• Lack of coordinated national pharmaceutical policy.

• Poor communication skills.

• Inadequate supervision

• Misleading beliefs.

• Irrational self-medication

• Inability to communicate problems

STEP 4: Factors Contributing to Irrational Use of Medicines (45 Minutes)

The following are the explanations of Factors Contributing to Irrational

Use of Medicines:

Lack of skills and knowledge

• Diagnostic uncertainty, lack of prescriber knowledge of optimal

diagnostic approaches, lack of independent information such as clinical

guidelines, lack of opportunity for patient follow-up, or fear of

possible litigation, lead to improper prescription and dispensing of

medicines

Inappropriate unethical promotion of drugs

• Most prescribers get medicine information from pharmaceutical companies

rather than independent sources such as clinical guidelines.

• Some countries allow direct-to-consumer advertising of prescription

medicines, which may lead to patients pressuring doctors for unnecessary

medicines, these can lead to inappropriate usage of medicines.

Profit from selling medicines

• In many countries, drug retailers prescribe and sell medicines over-the-

counter.

• The more they sell the more income they generate, leading to overuse of

medicines, particularly the more expensive medicines

Overworked and patient load to health workers

• Many prescribers have too little time with each patient, which can result

in poor diagnosis and treatment.

• In such circumstances prescribers rely on prescribing habit as they do

not have the time to update their knowledge on medicines.

• A prescriber may be forced to prescribe without proper diagnosis and thus

prescribe inappropriate medication.

• Too many patients also for dispensers may lead to medication errors and

irrational dispensing.

Lack of coordinated national pharmaceutical policy

• Less than half of all countries implement the basic policies recommended

by WHO to ensure the appropriate use of medicines.

• These include appropriate measures and infrastructure for monitoring and

regulation of medicines use, and training and supervision for prescribing

health workers.

Poor communication skills

• Rudeness of the dispenser or language barrier between the dispenser and

the patient leading to misunderstanding of the use of medicines by the

patient.

• Medical practitioners & other health professional giving less time to the

patient & not explaining some basic information about the use of drugs.

Inadequate supervision

• Poor or inadequate supervision may lead to irrational dispensing, such as

not following good dispensing practice (e.g. adequate labelling, adequate

instructions, adequate dose, etc.)

Misleading beliefs

• People tend to think for example that injectables are better than

tablets, or imported medicines or expensive medicines are better than

locally manufactured or cheap medicines respectively.

Irrational self-medication

• Taking medicines without prescription or consultation

Demand from the patient

• To satisfy the patient expectations and demand of quick relief, clinician

prescribe drug for every single complaint. Also, there is a belief that

“every ill has a pill” All these increase the tendency of polypharmacy.

Inability to communicate problems;

• Communication barriers, which lead to wrong diagnosis and therefore wrong

prescription, consequently wrong dispensing.

• Communication barriers may include language, or/and stigma.

Figure 1.2 Factors Influence Use of Medicines

STEP 5: Key Points (05 Minutes)

• Many interrelated factors influence medicine use.

• The health system, prescriber, dispenser, patient, and community are all

involved in the therapeutic process, and all can contribute to irrational

use in a variety ways.

• Less than half of all countries implement the basic policies recommended

by WHO to ensure the appropriate use of medicines.

• These include appropriate measures and infrastructure for monitoring and

regulation of medicines use, and training and supervision for prescribing

health workers.

STEP 6: Evaluation (05 Minutes)

• What are the factors contributing to irrational use of medicines?

• Outline five demands from the patient which can lead to irrational use of

medicines

References:

Cooper, J. W., Gunn, C., & Carter, S. J. (2008). Cooper and Gunn's

dispensing for pharmaceutical students (12th ed.). New Delhi, India: CBS.

Rees, J. A., Smith, I., & Watson, (2012) J. Pharmaceutical practice (5th

ed.). London, United Kingdom: Churchill Livingstone

Bentley, A. O., & Rawlins, E. A. (1977). Bentley's textbook of

pharmaceutics (8th ed.). London, United Kingdom: Bailliere Tindall.

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