NTA Level 5 • Semester 1 • PST05105

Problems Associated with Irrational Medicine Usage

Rational Use of Medicines • Source Session/Topic 4

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Session 4: Problems Associated with Irrational Medicine Usage

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 problems associated with Irrational Medicine Usage

• List Problems Associated with Irrational Medicine Usage

• Explain Problems associated with irrational medicine usage

Resources Needed:

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

• Figure 4.3 complications related to irrational 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: Introduction of Problems Associated with Irrational Medicine Usage

(30 Minutes)

• Medicines play an important role in healthcare delivery, and when used

properly, can help cure diseases, relieve symptoms, and alleviate

patient suffering.

• Irrational use of medicines remains a major issue facing most health

systems across the world.

• Worldwide more than 50% of all medicines are prescribed, dispensed, or

sold inappropriately, while 50% of patients fail to take them

correctly and about one-third of the world's population lacks access

to essential medicines.

• The problem of irrational medicine use is known to be worse in

developing countries with weak health systems, where mechanisms for

routine monitoring of medicine use are often not well developed or are

at times non-existent.

STEP 3: Types of Problems Associated with Irrational Medicine Usage (30

Minutes)

|Activity: Buzzing (10 minutes) |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

|What are the problems associated with irrational medicine usage? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

|WRITE their response on the flip chart/board |

|CLARIFY and SUMMARIZE by using the content below |

Incorrect use of medicines occurs in all countries, causing harm to people

and wasting resources, consequences include:

• Antimicrobial resistance.

• Adverse drug reactions and medication errors.

• Lost resources.

• Eroded patient confidence

• Treatment failure leading to unnecessary financial burden

• Increase of toxicity risk

• Non-compliance to drug regimen.

STEP 4: Problems Associated with Irrational Medicine Usage (45 Minutes)

The following are the explanation of the problems associated with

irrational medicine usage

Antimicrobial resistance

• Overuse of antibiotics increases antimicrobial resistance and the

number of medicines that are no longer effective against infectious

disease.

• Many surgical procedures and cancer therapies are not possible without

antibiotics to fight infection.

• Resistance prolongs illnesses and hospital stays, and can even cause

disability and death.

Adverse drug reactions and medication errors

• Harmful reactions to medicines caused by wrong use, or allergic

reactions to medicines can lead to increased illness, suffering and

death.

• Adverse drug reactions have been estimated to increase treatment cost

each year.

Lost resources

• Out-of-pocket purchases of medicines can cause severe financial

hardship to individuals and their families.

• If medicines are not prescribed and used properly, the income of

public and personal funds are wasted.

Eroded patient confidence

• Exacerbated by the overuse of limited medicines, drugs may be often

out of stock or at unaffordable prices and as result erode patient

confidence.

• Poor or negative health outcomes due to inappropriate use of medicines

may also reduce confidence.

Treatment failure leading to unnecessary financial burden

• Misuse, underuse and over-use of medicines waste resources – often out-

of-pocket payments by patients and result in significant patient harm

in terms of poor patient outcomes/treatment and adverse drug

reactions.

Increase of toxicity risk

• Drug toxicity can occur as a result of over-ingestion of a

medication—having too much of a drug (irrational use) in a person's

system at once.

• Drug toxicity occurs when a person has accumulated too much of a drug

in his bloodstream, leading to adverse effects on the body.

• Drug toxicity may occur when the dose given is too high or the liver

or kidneys are unable to remove the drug from the bloodstream,

allowing it to accumulate in the body

• In this case, irrational use of medicines can cause morbidity or

mortality in the society

Non-compliance to drug regimen

• Treatment regimens are only effective if the patient is willing to

follow the plan.

• Compliance is the extent to which a patient adheres to a treatment

regimen, primarily involves following the medication instructions, but

it also can include lifestyle modifications, as well as keeping follow-

up medical appointments

• Noncompliance may lead to relapse, aggravation of the disease state,

hospitalization, escalating health care costs, and even death.

• Pharmaceutical personnel have a major impact on compliance rates

through fighting against irrational use of medicines.

Figure 4:3Complications related to irrational use of medicines

[pic]

STEP 5: Key Points (05 Minutes)

• Promoting the rational use of medicines requires effective policies

as well as efficient collaboration between health professionals,

patients, and entire communities.

• Adequate understanding regarding the relevant aspects of medicine use

on the part of all stakeholders is essential to drive collaborative

efforts towards addressing the problem of irrational medicine use.

• Tackling the issue of irrational medicine use is considered to be

essential not only to improve healthcare delivery towards ensuring

patient safety, but also to allow for optimal utilization of

resources.

STEP 6: Evaluation (05 Minutes)

• What are the problems associated with irrational medicine usage?

• What are manifestations which hinder patient confidence in health

institutions?

References:

Dean, B., Schachter, M., Vincent, C, Barber, N (2002).Lancet: Causes of

prescribing errors in hospital inpatients: a prospective study.

359:1373–8.

Knudsen, P., Herborg, H., Mortensen, A,R., Knudsen, M., Hellebek, A

.(2007). QualSaf Health Care:Preventing medication errors in community

pharmacy: root-cause analysis of transcription errors.16:285–290.

Lesar, T.S., Briceland, L, Stein, D, S. (1997). JAMA:Factors related to

errors in medication prescribing.. 277:312–317.

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