Introduction to Irrational Use of Medicines – PST05105 Rational Use of Medicines
NTA Level 5 • Semester 1 • PST05105 Introduction to Irrational Use of Medicines Rational Use of Medicines • Source Session/Topic 2 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 2: Introduction 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 over view of irrational medicines use • Identify types of irrational Medicines use • Describe dispenser’s influence on irrational use of medicines • Describe prescriber’s influence on irrational use of medicines • Give reasons for irrational use of medicines to continue Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Handout 2.1:Factors underlying irrational Use of Medicines SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 Minutes |Presentation |Introduction, Learning Tasks | |2 |20 Minutes |Presentation |Introduction to Irrational Use Of | | | | |Medicines | |3 |30 Minutes |Presentation |Types Of Irrational Medicines Use | | | |Buzzing |Based on Prescribing Practice | |4 |20 Minutes |Presentation |Dispenser’s Influence on Irrational | | | | |Use of Medicines | |5 |20 Minutes |Presentation |Prescriber’s Influence on Irrational| | | | |Use of Medicines | |6 |15Minutes |Presentation |Reasons For Irrational Use of | | | |Brainstorming |Medicine to Continue | |7 |05 Minutes |Presentation |Key Points | |8 |05 Minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (05Minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Introduction to Irrational Use of Medicines (20Minutes) Irrational use of medicines: • Is the use of medicines in a way that is not compliant with rational use, this incorrect use may take the form of overuse, underuse and misuse of prescription or non-prescription medicines Irrational use of medicines is a serious public health problem worldwide and can be seen as: • Use of too many medicines per patient • Inappropriate use of antimicrobials, often in inadequate dosage and insufficient duration; • Overuse of injections when oral medication would be more appropriate; • Failure to prescribe in accordance with clinical guidelines including standard treatment guidelines and prescribing policy; and • Inappropriate self-medication, often of prescription-only medicines. STEP 3: Types of Irrational Medicines Use Based on Prescribing Practice (30 Minutes) |Activity: Small Group Discussion ( 05 minutes) | |DIVIDE students into small manageable groups | |ASK students to discuss on the following question | |Give types of irrational medicine use base on prescribing practice | |ALLOW students to discuss for 10 minutes | |ALLOW few groups to present and the rest to add points not mentioned | |CLARIFY and SUMMARIZE by using the contents below | The following are some types of irrational use of medicines based on prescribing practices that observed in health institutions: • Under-prescribing; • Over-prescribing • Incorrect prescribing or dispensing • Extravagant prescribing • Multiple prescribing • Poly-pharmacy • Under-prescribing: o Occurs when needed medications are not prescribed and the dosage prescribed is inadequate • Over-prescribing: o Occurs when the prescribed drug is not needed by the patient and the quantity of drug dispensed is too much for current course of treatment • Incorrect prescribing or dispensing: o Occurs when prescribing the wrong drug, dispensing the wrong drug due to the prescription being prepared improperly and adjustments are not made for existing medical, genetic, environmental or other conditions • Extravagant prescribing: o Occurs when prescribing a more expensive branded drug when there is a less expensive generic drug of good quality available and treating the patient symptomatically instead of treating the serious illness, hence making the patient use a lot of his funds. • Polypharmacy o The use of too many medicines per patient when more than one medicine is used unnecessarily to treat same condition. STEP 4: Dispenser’s Influence on Irrational Use of Medicines (20 Minutes) The dispenser plays a crucial role in the therapeutic process, on the other hand: • Dispensing quality may be affected by training and supervision the dispenser has received and the medicine information available to the dispenser. • A shortage of dispensing materials and short dispensing time caused by heavy patient load may also have an adverse impact on dispensing. • As with prescribers, dispensers, especially private drug sellers, may have a financial incentive to dispense irrationally. • Drug sellers in retail outlets are rarely trained and there is little knowmonitoring or supervision. • Low status of dispensers affects the quality of dispensing. Dispensing characteristics that lead to Irrational Medicine Use are: • Incorrect interpretation of the prescription • Retrieval of wrong medicines/ingredients • Inaccurate counting, compounding, or pouring • Inadequate labelling • Unsanitary procedures packaging: o Poor-quality packaging materials o Odd package size, which may require repackaging o Unappealing package Pharmaceutical personnel promoting irrational use of medicines by: – • Recommending prescription medicines even though the law does not permit it. • When recommending Over-The-Counter (OTC) medicines, he may recommend/provide: o Irrational medicines and combinations. o Inappropriate dosage. o Improper medicine for a particular condition. o Insufficient or inappropriate information about the medicines, dosages, timing set leading to improper dosing by the patient. • By being tempted to stock and push/recommend medicines that are costly, or those which offer better schemes/profit margins, but compromise on genuine need and rationality. • By following/copying prescribing patterns similar to those of physicians. • By passing on misleading information from pharmaceutical companies/medical representatives to clients. [pic] STEP 5: Prescriber’s Influence on Irrational Use of Medicines (20 Minutes) Prescriber can be affected by internal and external factors such as: • He or she may have received inadequate training either pre-service or in- service, or his or her prescribing practices may have become outdated because of a lack of continuing education