1. Promoting Rational Drug Use in the Community Prioritising Community Drug Use Problems

2. WHO 2 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

3. WHO 3 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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)

4. WHO 4 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

5. WHO 5 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

6. WHO 6 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

7. WHO 7 Prioritising community drug use problems Promoting Rational Drug Use in the Community Common forms of inappropriate use 5) Overuse of relatively safe drugs common categories include  vitamins  analgesics  tonics  antidiarrhoeals (for adults)

8. WHO 8 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

9. WHO 9 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

10. WHO 10 Prioritising community drug use problems Promoting Rational Drug Use in the Community Prioritising - possible criteria  scale of the problem  seriousness of the adverse effects  economic cost  appropriateness for intervention  …..

11. WHO 11 Prioritising community drug use problems Promoting Rational Drug Use in the Community Rating looks at each problem separately

12. WHO 12 Prioritising community drug use problems Promoting Rational Drug Use in the Community Ranking compares problems against criteria

13. WHO 13 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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

14. WHO 14 Prioritising community drug use problems Promoting Rational Drug Use in the Community 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