factors affecting rational drug use

A questionnaire was developed and administered to households in 5 regions in Saudi Arabia and other Gulf countries. 4. Given the paucity of information available and the importance of the topic the authors report on all 45 studies identified. and from January to April 2001, once the algorithm was in operation. Overall, the mean (SD) number of medicines per household in Saudi Arabia was 8.0 (4.3). The goal of this work is to assess the impact the definition of a clearly laid-out criteria algorithm for therapeutic swapping regarding calcium antagonists. However, on question related to justification of FDC, interns were found to be better informed as compared to the II MBBS students (p<0.05). The most consistent predictors of compliance have been found to be certain health-related beliefs on the part of the patient, various characteristics of the regimen, and some aspects of the interaction between physician and patient. Previous studies suggest that many of these medicines may be in a condition suitable for re-use. The purpose of this study is to determine the drug-use habits in North Cyprus and to prepare a demographic study of drug wastage. Generalized Anxiety Disorder (GAD) is a highly prevalent condition whose course of illness is often chronic in nature and fluctuating in severity. The mean out-of-pocket expenditure (based on the percentage of annual income) for medications was 0.72% for households in Saudi Arabia compared with 0.48% in other Gulf countries. Thus, rational drug use is an essential factor in ensuring patient safety, effective management of diseases and promoting good health care services, ... At this point, the most common mistake made by patients is to take action with their own knowledge about the drug instead of following the doctor's instructions. Despite the value of the method, and the favor encountered by the patients, we must not forget that the use of autologous blood is not costless. As the interaction was primarily between the childs mother and the doctor the mother was designated as "the patient." for pharmaceutical businesses. These include lack of essential drugs, gaps in training and weak implementation of policy guidelines. Factors Affecting Rational Choice Most consumer behavior analyses and programs seek to dig out consumers’ needs and wants, which direct their purchasing and decision behaviors. The analysis of results focused on some organizational problems that need to be avoided in order to show the methods maximum benefits. This review unifies the current spectrum of compliance literature in order to outline and clarify the adherence situation. However, while most governments are interested in ensuring availability and access to drugs, the issue of adequate use of drugs remains a low priority in most third world countries. psychiatric patients, monitoring of drug use can benefit patients. II MBBS students were found to be better informed as compared to the interns (p<0.05) on questions related to rational drug therapy. on rational drug use (RDU) and the factors influencing prescribing. Other variables included troubles with police and security agents, trouble in school, having medical problems, and problems with parents. Factors that have led sudden realization for rational drug use are. Strategies to address irrational medicine use can be characterized as educational, managerial, economic, or regulatory. On single question pertaining to role of pharmacist, interns were found to be better informed than II MBBS students possibly due to their better understanding of patient-pharmacist relationship.Conclusions: Our study highlights the significance regarding knowledge of rational drug therapy and fixed dose combination (both rational and irrational), both rational and irrational, amongst both interns and II MBBS students while identifying the possible areas of interventions to make them rational clinicians. To determine the association between medication-related risk factors and poor patient health outcomes from observations in the patients' homes. In 53.7 percent of the prescriptions no duration for treatment was specific and 96.5 percent of the prescriptions did not indicate drug strength. This, Improving airspace and runway utilization is the key to reducing flight delays with the rapid development of the air transport industry. This study allowed showing the medico-pharmaceutical impact on the quality of antibiotic treatments in UTI. WHO … However, aging also brings about bodily changes that result in increased effects and prolonged action of many drugs. �^(#�K�A��(!��̖�G#H30m�����$�8h17Ô�'O��*¤˨ސ����`]r,%[A��N���,eW�4?CT&X�d��}�2�w Sf.V Failure to adopt the rational pattern of prescribing and dispensing by health professionals represents a significant risk to the safety of patient and lead to pharmaceuticals wastage. From these data, mean medication wastage was estimated to be 25.8% (Saudi Arabia) and 41.3% (other Gulf countries). The present study aimed to evaluate the reliability and validity of the questionnaire of the prevention of induced demand for medicine prescription. Promoting the Rational Use of Medicines Incorporating rational use topics into pre-service training curricula Ensuring that pre-service training programs for pharmacists and other health professionals includes robust rational use curricula is a primary way SIAPS aims to build in-country capacity to responsibly manage medicines. The HMCs were inventoried and the participants were interviewed. Of the top 20 most returned capsules, 10 were 'stat' dispensed. ... Days of drug use affecting the dose. The problems which occurred and the cost are discussed. Understanding: of Doctors?? One quarter of the participants were of the opinion that cheaper generic drugs were counterfeit drugs. The ways in which people cope with the stress and challenges of disease is the subject of this paper. We measured the effect of both difficulties in reading, as well as difficulties in understanding prescription labelling, on non-compliance with drug treatments among seniors. Many of these ADR's are dose-dependent and preventable. The standard procedure was to make an audio tape recording of the entire interview then question the mother immediately afterward concerning what she had expected from the visit and her reactions to it. Background: When the basic principle of rational use of drugs is not fulfill it leads to irrationality which further leads to adverse effects and toxicity. However, despite improved availability, pharmaceuticals are frequently used irrationally. Like so many others, the home that you and your siblings grew up in also plays a significant role in your addiction. The definition implies that rational use of drugs, especially rational prescribing, should meet certain criteria as follows: • Appropriate indication. activity period is presented. One physician was able to generate refill durations nearly double that of the average duration of medication refills seen in the patients consulting the several other nearby physicians. Further, the regimen can be simplified and tailored to the patient's individual activity pattern and careful follow-up by a variety of means can be provided. Medical educators and researchers recommend a patient-centered interviewing style, but little empirical data exists regarding what aspects of physician communication patients like and why. CONCLUSION: Establishing an algorithm for therapeutic swapping improves compliance with the Pharmacotherapeutic Guidelines during calcium antagonist prescription and the quality of therapeutic swapping as performed by pharmacists regarding this group of drugs. Failure to apply rational approaches to drug use in the elderly will bring along many problems. Factors affecting the rational use of NSAIDs in self-medication book By L. Pristianty, G.N.V. Twenty-one percent of the drugs were expired, 9% were not stored in the original container, and the package insert was missing for 18%. Aim To identify and quantify medicines returned to Otago pharmacies, specifi-cally to identify what types of medications were being returned and whether these items were 'stat' dispensed (i.e. Therapeutic Innovation and Regulatory Science. Background Inappropriate use of antibiotics is a global public health challenge and has been associated with antibiotic resistance. The pharmaceutical practice is essential in giving health information services, and this is because of the lack of knowledge about the rational use of medicine (RUM) in the community. The aim of this study was to assess the impact of medico-pharmaceutical partnership on the quality of antibiotic treatment in urinary tract infection (UTI) within rehabilitation center. Pharmacy customers (N = 288, aged 18-80 y) were visited in their homes by pharmacy students. & Raymond, T. (2014). An expert survey of physical education teachers. The results of this study suggest that there is a role for patient education about proper disposal of unused and expired medications. The causes of polypharmacy and noncompliance with the limited list are discussed with emphasis on the essential drug list as a method of rationalizing prescribing in primary healthcare. & Alabbadi, I. 2-The educational programs for the doctors and pharmacists lack certain subjects with respect to rational use of drug that need to be targeted by the government to enrich the curricula. Epidemiological data were collected from child and adolescent out-patient files at two time periods: time period A, 1990-1994, n = 455 (sample A) and time period B, 2000-2002, n = 476 (sample B). Their authority to make treatment decisions was made explicit throughout. Nonetheless, this review of the available literature concludes that pharmacist interventions can improve patient outcomes. Two thirds had accepted generic substitution in the pharmacy whereas the remaining participants had either opposed or were unaware of the substitution. Returned packs had a median of 17 months remaining before expiry and one-quarter of packs (1248 out of 4291) were suitable for possible re-use. ... Irrational medicine prescription imposes an additional burden on the healthcare system and wastes health resources, thereby leading to health and economic costs for patients [8,10]. Sustaining the availability and rational use of safe and effective drugs is a major problem in developing countries. Optimizing medicines management: From compliance to concordance, Pratisyen hekimlerin aki{dotless}lci{dotless} ilaç kullani{dotless}mi{dotless} konusunda bilgi ve tutumlari{dotless}ni{dotless}n deǧerlendirilmesi, Medication noncompliance: What we know, what we need to learn, CORNELL U, ITHACA, NY, YALE U SCH OF MEDICINE, NEW HAVEN, CONN, & INDIANA U SCH OF MEDICINE, BLOOMINGTON PATIENT PARTICIPATION IN A PEDIATRIC PROGRAM, Patients?? A significant reduction in the early termination rate (45.7%) was noted in sample B. The aim of this study was to compare evidence, collected at two time periods in a Community Mental Health Center in Athens, on factors affecting treatment compliance. Understanding of medication use was best established using a structured exploration of patients' beliefs about their illness and medication. A survey of prescribed medicines was carried out in 192 homes, broadly representative of households in England and Wales. 2) Environment. Studies have shown that genetics alone does not an addict make. Method: The study was conducted with the physicians working in family health centers and hospitals in Malatya province center with face-to-face interviews. 204 general practice patients living in their own homes and at risk of medication-related poor health outcomes. Methodology: the objective of this observational and descriptive study was to identify potentially inappropriate medications in elderly people older than 65 years of Los Guidos de Desamparados, San José, Costa Rica; based on the application of the Beers-STOPP-START criteria. Incineration is the best disposal option currently available for waste medications. Not all patients are ready or suitable for shared decision making in management of their condition, some still preferring a doctor-led decision but an increasing number want a partnership approach. Adverse drug reaction reporting helps the drug monitoring system to detect the unwanted effects of those drugs which are already in the market. Respondents who preferred different communication styles articulated different sets of values, important physician behaviors, and physician-patient role expectations. 1576 0 obj <>/Filter/FlateDecode/ID[<06452D20F172686F6A772114F858F34D><86E8AA2F04A3C44F80AC8B2B125F4E0E>]/Index[1564 29]/Info 1563 0 R/Length 70/Prev 319498/Root 1565 0 R/Size 1593/Type/XRef/W[1 2 1]>>stream The compliance rates of this 3 QI allowed to assess the quality of the antibiotic treatment in urinary tract infection. Their specific reactions were less favorable. Nine hundred and thirty-four return events were made from 910 patients, comprising 3765 items worth pound 33,608. IT Compliance and Controls, [Assessing an algorithm for the therapeutic swapping of calcium antagonists], Problem of shortage of motor activity students. An analysis has been made about the quantity of predonated blood/plasma units, the quantity actually transfused and use of homologous blood. Predeposit, preoperative hemodilution and intraoperative recovery, are methods that should all be available in a general surgery department to manage in the best way the single patients blood/plasma needs, reducing post-transfusion complication. 2003; 11 (3): 126-135 Abstract English Based on the good practice, in Afghanistan, 1- patient centered approach need to be improved by providing sufficient information on their drug and being interactively engaged with patients. The fact that 76% of these anxious mothers were more or less satisfied with the doctors performance in their brief encounter in the clinic was reassuring. Non-drug therapies such as interpersonal and cognitive therapies are often also found helpful in treating patients with GAD. In another number of cases predonated blood units were not used at all (61/34%). Researchers, however, in their effort to explore all facets of the current compliance situation, have produced a complex construct, making it exceedingly difficult for clinicians and researchers to understand the problem. A total of 450 questionnaires containing 36 questions were handed out in 5 major cities of North Cyprus. Methods A random sample (159kg, 12%) of the 1294kg of medications returned for destruction over a nine-month period from the Otago region were identi-fied and quantified based on generic name, trade name, strength, form, quantity, subsidy amount, cost per unit, stat or non-stat, and therapeutic classification. Conclusion: Noncompliance is a major worldwide medical problem and concordantly, there have been numerous studies and reports performed to define the meaning of the problem as well as to make suggestions. Factors associated with the primary care role of pharmacists are discussed and include education, social and political pressures and professional attitudes. ... Irrational use of medications (increased use of over the counter (OTC) drugs, prescription, non-prescription drugs and traditional medicines) leads to increased health hazards, failure of therapy and lack of patient satisfaction making medication use and safety a global issue 2,3,4,5 . Prescription drugs accounted for 34% of the total. Data of this nature can be used to aid formulary management at the institutional level. WHO reports show that efforts to promote rational antibiotic use in developing countries are poor. 3-Strategies are needed to establish pharmacovigilance unit, to accredit the drug … The drugs prescribed from Essential Drug List were 75.08%. Purpose is reducing flight delays and improving the utilization of the airspace and runway on the basis of keeping safety. 1 Presented By Farzana Sultana BPH : 04806682 Department of Pharmacy Stamford University Bangladesh 2. Expenditures for prescription and over-the-counter medications constitute a large percentage of total health care costs. All drug dispensers check the name of the drug (100%), age of the patient (90%), the dosage form of drug (96.7%), the route of administration (90%), the duration of therapy (86.7%), and frequency of administration (86.7%) for prescription papers. Of 50 prescribers and 30 dispensers, 58% and 83.3% were males, respectively. This paper describes a research project conducted to determine the patient's view of rational drug therapy—what it means for him/her. The completed questionnaires were then collected and analysed statistically for responses.Results: Mean average score obtained by II MBBS students (score - 36.66marks) was significantly better than interns (score- 20marks) which probably may be due to pharmacology teaching they were undergoing. Taking into account that younger people showed a significantly higher intention of self-medication, a sustained awareness of the risks of self-medication is warranted for the future. 1592 0 obj <>stream Student's t test and the Pearson chi2 test were used in order to explore the correlation of the variables with treatment completion in each sample. Looking back at the development of. A developmental qualitative study using a modified action research design. By opening up and rebalancing the discussion about medication, we can expect a consultation which is more satisfying for both parties and flowing from this, more effective, focused prescribing of medication which is more likely to be adhered to by the patient. “It is use of the drugs noncompliant with the rational use of drugs” as defined above. Medical schools continue to leave the learning of the "art" of medical practice to the individuals own initiative and intuition which is a serious omission. Sixty-eight PI were made by pharmacist about urinary tract infection treatment (overdosage or under-dosing, duration unknown, inadequate route of administration). At the same time, 3 quality indicators (QI) were followed: duration, dosage, antibiotic susceptibility. [1][1] Self-medication, although generally acceptable in terms of indication and dosage, was commonly practiced, also with prescription drugs. The nation is suffering with both irrational use and also a huge report on drug abuses. Variables pertaining to the patient, his family and recommended treatment were examined. Participants who preferred the biomedical physician (31%) liked that she prevented harm, demonstrated medical authority, and delivered information clearly. Interventions are required for a rational use of medicines that improve the quality of life of the elderly. European Journal of Social Sciences, 28(2), 380-391. The decision to prescribe drug(s) is entirely based on medical rationale and the drug therapy is an effective and safe treatment. A cross-sectional study was conducted in 72 Belgian community pharmacies. This study was conducted to identify the extent of medication use and wastage among families in the Arabian Gulf countries, with an emphasis on Saudi Arabia. However, injecting drugs, cannabis use and use of opioids before imprisonment significantly increased the chances of substance use within prisons. The result was a categorization of the literature into six segments, including the causes of noncompliance and possible solutions, articles identifying adherence as a problem, analysis of adherence with respect to specific ailments, and exploration of the pharmacist's role, the patient's role, and the physician's role with respect to compliance. This chapter presents some important compliancy regulations. continuouslyused, while 38.2% used four or more drugs. The study associated triggers of drug use with factors such as unemployment, suspension, and dismissal from work and loneliness due to being abandoned by wife, husband, and/or friends. Unused medicines are returned in substantial quantities and have considerable financial value, with many in a condition suitable for re-use. permanence at home and 225 (17%) cases got expired date; the cases of medications are to treat affections of the cardiovascular (29%), digestive (22%) and skeletal muscle (12%) system; 78,64% of the elderly presented polypharmacy (>5 medicines) and 71% had at least one potentially inappropriate medication, highlighting furosemide (18 cases), amlodipine (15 cases), atenolol (14 cases), enalapril (11 cases), irbesartan (6 cases), famotidine (35 cases), omeprazole (18 cases), lovastatin (7 cases), metoclopramide (7 cases), hyoscine butyl bromide (7 cases), ibuprofen (31 cases), sulindac (12 cases), indomethacin (9 cases), fluoxetine (18 cases), amitriptyline (12 cases) and chlorpheniramine (9 cases). A mean of 31 +/- 17 (range 6-136) drug packages were identified per household; in one-third of the cases, the packages were not stored safely. Nearly 1/5 149 mothers felt they had not received a clear statement of what was wrong with their baby; almost half of the entire group were still wondering when they left the physician what had caused their childs illness. Results Of the top 20 most returned tablets all were 'stat' dispensed. The visit usually is short and generally yields a specific recommendation from the doctor to the parent. The way in which the patient copes with his illness spells the difference between optimum recovery or psychological invalidism. Increased consumption of drugs in the elderly entails greater risk of problems [Ökat läkemedelsintag... Chapter eight. The medication-related risk factors were examined as determinants of patients' self-reported health related quality of life (SF-36) and their medication use, as well as physicians' impression of patient adverse drug events and health status. Conclusion: In order for valid and reliable questionnaires, the views of the target group and experts must be considered and all the psychometric stages should be accomplished. Identifying and discussing these barriers improved management for some. Prescriber lack of knowledge and experience is only one factor in irrational medicine use. A major global problem The purpose of this study was to assess the factors that influence rational drug use among doctors and pharmacists in public hospitals in Meru County. In addition, individual patients at high risk of developing akathisia need constant vigilance as immediate resolution maintains quality of life. For ITers, the biggest impact of the rules and regulations of compliance generally relates to controlling, securing, and managing data. In all, 73% of the participants were using generic drugs at the time of the interview. Authors describe the impact of an autotransfusion program, in a general surgery university department, focusing on management and cost problems. D. Dose mentioned on a product label. 4. classes, particularly dopamine antagonists, have been linked with akathisia. December 31, 2015 were included in this study. Most of the participants get their medication with prescriptions (43.5%) and also pay attention to expiry dates while purchasing (80.6%). In addition, expired medication and poor adherence were also associated with poor health outcomes, however, not independently. Methods: This descriptive study was conducted after designing the primary questionnaire (63 items). Each practice is discussed in more detail in this section. Results: The International Network for the Rational Use of Drugs (INRUD) has been established to help address this problem. This study aims to explore how long-term drug users with a Pakistani background living in Oslo (Norway) perceive generic substitution and how generic substitution influences drug adherence in this population. Patients using treatment sub-optimally and having poor clinical control were offered extended consultations to explore their situation. Buspirone is probably the treatment of choice when prolonged therapy is indicated because it does not produce physical dependence, dose not interact with alcohol, and does not cause psychomotor impairment. According to a fact sheet by WHO (May, 2010) about the rational use of medicines, more than 50% of all medicines are not correctly prescribed, dispensed, and sold; and more than 50% of patients take their drugs incorrectly. The limitation of this study is that only those factors pertaining to the service's organization and functioning were investigated. We conducted semi-structured interviews with 230 adult medicine patients who viewed videotapes depicting both patient-centered and biomedical physician communication styles. The results of this study highlighted that the average number of drugs prescribed was 2.751. Rational drug use attained more significance nowadays in terms of medical, socio economical and legal aspect. This study tests a new, behavioral model which employs mothers' health motivations, perceptions, and attitudes as predictors of giving oral penicillin and keeping follow-up appointments for otitis media. Now recognised as a fundamental corporate function, compliance management is the process that co-ordinates compliance activities, provides records retention, archiving and access, enables management review and ensures that due diligence adherence to rules and regulations can always be substantiated. Even though, the consumers and prescribers expectation mismatches due to that the over consumption of medicines which also cause irrationality, especially occurs in the case of antibiotics use. Children are brought to this walk-in clinic with a great variety of acute illnesses or accidental injuries invariably accompanied by a parent. The primary objective of the Network is to identify through a coordinated set of country-based research projects a set of effective interventions to recommend as policy options for the promotion of rational drug use. The mean (SD) family size of household respondents from Saudi Arabia was 6.60 (3.20) members, with 0.32% reporting no medicines present in the household, 81.8% of households reporting 5 or more medicines, and 29.9% of respondents reporting having at least 10 medications at home. Rational use of drugs is defined by WHO as “patients receive medications appropriate to their clinical needs, ... risk factors, health data, cultural factors, health literacy, and access to medications or other aspects of care. Modern compliance research is based on actual medication behavior, paying little heed to the patient's ideas, values, or attitudes. Background: The present study was designed to assess awareness regarding rational drug therapy and fixed dose combinations (FDC) amongst interns and II MBBS students in a tertiary-care teaching hospital in Maharashtra, India.Methods: This cross-sectional, questionnaire-based study containing MCQ and analytical questions on rational drug therapy, fixed dose combinations and role of Pharmacist in dispensing correct drug to the patients was carried out in both interns (n=80) and II MBBS students (n=100). %%EOF Investigating the factors affecting doctor’s prescribing behavior in Jordan: Anti-hypertensive drugs as an example. %PDF-1.5 %���� Less than 20% had ever been given advice about medication disposal by a health care provider. The necessity of changing approaches to the process of physical education and the development of recommendations and actions to improve the quality of education in physical education. h�b```�"~UAd`��0p40002p�7Y��U�)P/�~�?�5����X����� �酧 Poor adherence tended to be most common among patients who were not fluent in Norwegian, patients who had concerns about medicine use, and patients who had accepted generic substitution in the pharmacy. Refering to Chinese and international main wake models, we propose to improve the existing wake standard, usage of modern wake separation systems and dynamic wake detection strategy with automated judgment method. Variables in each model category were found to have useful explanatory and predictive value. Clinicians refined a consultation model during ten 'Balint-style' meetings that ran in parallel with the analysis. A positive patient-therapist relationship usually leads to successful completion of therapy. Methods: 153 respondents were non-compliant with their drug treatment. Over the last decade, pharmaceutical selection, procurement, distribution, and financing have improved as a result of essential drugs programs.

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