1. Social Pharmacy Lecture no. 6 Rational use of drugs Dr. Padma GM Rao
RAK COPS

2. Rational Drug Use & essential Drug Concept

3. Learning objectives Explain rational drug use with its importance
Define the term Essential Drug Concept
Some understanding on national drug policy
Common problems associated with drug use
Pharmacists role in promoting rational drug use.
Guidelines for rational prescribing

4. What is rational drug Use (RDU)?
Rational Drug Use is defined as the use of an appropriate,effecacious,cost-effective and safe drug for the right indication in the right dose, right formulation at right intervals for the right duration of time.
Advantages of RDU
Safe
Effective
Ecnomical
Used when required

5. Importance of rational drug use
Affect the health of individuals and communities, health care cost and the environment.
Irrational drug use leads to ineffective and unsafe treatment, worsening or prolonging of illness and adverse reactions.
Inappropriate treatment also increases the cost to the patient
Antibiotic resistance

6. Irrational prescribing practice
Prescribing drugs of no proven value
Prescribing empirically
Prescribing drugs for self- limiting conditions
Overdosing and under dosing of drugs
Prescribing costly drugs
Using injectables when oral drugs are available

7. Persons involved in irrational drug use
Patient
Self medication
Compliance
Physicians
Inadequate knowledge
Financial interest
Pharmacist
Errors in dispensing

8. Manufactures
Financial interest
Misleading information by medical
representatives

9. Reasons for irrational drug use
Unrestricted entry of prescription drugs
Lack of drug information
Inadequate training & skills
Confusion due to brand names
Aggressive marketing strategies
Increased work load for doctors
Cost factors

10. Reasons contd.. Preference to company or drugs Attitude of people
Professional competition
Lack of diagnostic facilities
Erratic supply & shortage of drugs
Lack of essential drugs

11. What does RDU require? Adequate diagnosis Correct prescribing of drugs
Non drug treatment
Correct dispensing
Patient’s adherence with therapy

12. How to promote RDU?
Entire health care team is essential to promote RDU .There are a wide range of activities to be performed to promote RDU Educational strategies
Development of clinical guidelines and
essential drug list
Basic training for health care professionals
In service training for health workers

13. Drug information centers
Consumer information & education
Managerial strategies
Regulatory strategies to promote RDU

14. RDU in a hospital setting
Drug Formulary
Drug & Therapeutic Committee(DTC/ PTC)
Drug use evaluation
Clinical pharmacists

15. Role of pharmacists in RDU
Pharmacists play a key role in the following
aspects of drugs
Procurement
Distribution
Dispensing
Education
Prescribing information
Pharmaceutical care

16. Drug procurement Selection of drugs should be based on
Needs of the situation
Cost-effective
Affordable & quality drugs
Controlled by the Pharmacy & Therapeutic Committee of the Hospital.

17. Objectives of procurement
Procure the most cost-effective drugs in right quantities
Select reliable suppliers of high quality drugs
Ensure timely delivery
Inventory control
Proper inventory control is done by monitoring the stocks and preventing out of stock situations.

18. Use of a good formulary or drug list- Restrict the no. & brand of drugs
Drugs with overdue expiry date should not be stored / dispensed
Information & education
Information about introduction of new drugs, policy changes regarding drugs, availability of drugs and drug related problems

19. Role of clinical pharmacists
Drug information
ADR monitoring and reporting
Drug therapy monitoring
More focused teaching on patient and the disease rather than on general information on drugss

20. Publication of drug bulletins
Monitoring of ADRs and reporting to the monitoring centers in hospital, region or country.
Education programs to create awareness regarding ADRs
Counseling programs – appropriate drug use and patient compliance.

21. Pharmaceutical care
Optimize patient’s health related quality of life and achieve positive and cost- effective clinical outcomes.
Individualized drug therapy plan in consultation with other health care professionals and the patient
Establish a professional relationship b/w the patient and other health care providers.

22. National drug policy(NDP)
Rational drug use is an extremely important part of NDP
What is NDP ?
The way in which the country regulates the availability, quality and use of drugs
To improve the health of the people.