who medicines strategy - libdoc.who.int - World Health Organization

WHO MEDICINES STRATEGY 2004-2007 | 114EO 7.1Rational use of medicines byhealth professionals and consumersadvocatedRationaleDecisions about the use of medicines arestrongly influenced by health professionalsand consumers. However, it is these twogroups which can be the most reluctant toimplement policies about rational use. Forhealth professionals and prescribers, rationaluse will often conflict with peer pressure and/orcommercial interests. For consumers, especiallywhere the treatment is free of charge or in theevent of serious illness, there is a natural demandto have the ‘latest’ treatment (on the assumptionthat this equates to ‘best’) regardless of cost. Bothof these groups are influenced by the marketingand promotional activities of product patentholders. Despite the scientific logic of rationaluse training and guidance material, such astreatment protocols, there is strong resistance totheir application.ProgressThere has been a major increase in the volumeof information in support of rational use, togetherwith increasing use of objective scientificevidence to formulate protocols and policiesat international and country levels. The rapidexpansion of movements such as the CochraneFoundation has made vital information readilyavailable. WHO has contributed to this processover the past 20 years through demonstratingthe value of evidence-based action. The EssentialDrug Monitor, a twice-yearly publication witha 40 000 print-run issued in five languages, isa major channel for advocacy among healthprofessionals and policy-makers. Some of thethemes covered have included prescribing skills,improving drug use, drug donations, networkingfor action, managing drug supply, access,antimicrobial resistance, medicines promotion,and 25 years of the essential medicines concept.Other networks concerned with promotingrational use of medicines have also beensupported, including INRUD, INDIA-DRUG (anemail discussion group) and the InternationalSociety for Drug Bulletins. In 2003, in response tothe increasing problem of patient failure to adhereto therapy for chronic diseases, WHO published areview of the evidence for action. 57Challenges remainingThere is a need to engage some of the majorplayers — manufacturers, prescribers, andproviders and consumers of medicines — onthe importance of ensuring the rational use ofmedicines. The challenge is to find ways andmeans to translate the logic of the existing rationaluse messages and practice into convinced actionby the majority of practitioners and consumers.Although intervention research during the pastdecade has helped identify strategies andinterventions that are effective in promotingrational use of medicines, many of these strategieshave not been taken on board by governments.In many countries today, more than half of allpatients are not treated in accordance withclinical guidelines (WHO/EDM rational drug usedatabase, 2003).