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

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WHO MEDICINES STRATEGY 2004-2007 | 122EO 7.5Consumer education enhancedin recognition of the growingsignificance of self-medication andof consumer access to knowledgeand advice of variable qualityRationaleConsumers of medicines are the final decisionmakerson the use of medicines, whetherprescribed or purchased over the counter withoutprescription. However, insufficient attention ispaid to consumer education on the importanceof rational use of medicines. Self-medication isincreasing in importance, either by default or asa result of deliberate public policy. In developingcountries today, out-of-pocket spending byconsumers is the main source of spending onmedicines. In many countries, the distinctionbetween prescription-only and over-the-countermedicines is meaningless as almost all medicinesare available for sale.ProgressThe need for skills development for communityeducation in rational medicine use has beenclearly identified in WHO research. In response,a new interactive and skills-oriented trainingprogramme on community education in therational use of medicines has been developedby WHO, in partnership with the Universityof Amsterdam and an experienced group ofdeveloped and developing country experts, andmade available in Asia and Africa. In addition,two manuals, one on investigating drug use incommunities and the other on interventionsto change medicines use in communities, arebeing prepared by partners at the University ofAmsterdam.Challenges remainingDespite the risks to personal health frommisguided self-medication or the inappropriateuse of prescribed treatment by consumers, the fullimpact of these practices cannot be quantified.The challenge is to promote rational use ofmedicines amongst consumers with the samelevel of success as the pharmaceutical industryachieves in marketing their products. As yetthere is limited information available as to whichare the most effective interventions for use indeveloping and transitional countries. Furtherresearch is needed in different environments andsectors.Meeting the challenges 2004-2007Over the next four years WHO will:> support efforts to provide information andeducation designed to improve rationaluse of medicines by consumers. The longtermaim of the training programme oncommunity education is to develop a networkof trained people committed to implementingcommunity education in rational use ofmedicines, evaluating the impact of theirwork, reporting on experience, and sharingexpertise.> promote and support systematic researchactivities aimed at identifying the mosteffective interventions for improving rationaluse.OUTCOME INDICATORS1999 2003 2007No. of countries that have implemented a nationalconsumer education campaign in the last two years#REPORTING % TARGET#REPORTING % TARGETna na na 72/120 60% 60%
COMPONENTS OF THE STRATEGY | 123EO 7.6Drug and therapeutics committeespromoted at institutional anddistrict/national levels.RationaleAn effective drug and therapeutic committee(DTC) will establish and monitor policiesand systems for medicines management inhospitals, health programmes or geographicalareas. Hospital DTCs are vital structures forimplementing comprehensive and coordinatedrational medicines use strategies in hospitals.They should be considered as a cornerstone ofthe hospital pharmaceutical programme, withresponsibility for developing and coordinatingall hospital policies related to pharmaceuticals,such as the selection of standard treatments andhospital formularies. These committees shouldalso be responsible for adapting the nationalclinical guidelines and essential medicines listto the needs of the hospital and for carrying outmedicines utilization studies and prescriptionreviews, as well as developing educationalstrategies to improve medicines use andmanagement.ProgressA WHO manual on the establishment andfunctions of DTCs was published in 2003. Incollaboration with MSH, an international coursewith accompanying materials was developed andfour international and four national courses wereconducted in 2000-2003. A web-based discussiongroup and a follow-up workshop for past DTCcourse participants were provided by MSH incollaboration with WHO. Several interventionresearch projects involving DTCs, aimed atpromoting better use of medicines, have beenor are currently being supported (in Cambodia,Ghana, Indonesia, Kenya, Laos, and Zimbabwe).Challenges remainingAlthough DTCs have been established in manydifferent settings, many of them fail to ensurethe correct management of medicines withinthe institution or area they represent. In manydeveloping countries, DTCs are hampered by ashortage of qualified staff and lack of capacity inmany hospitals and by the lack of incentives fromgovernments or hospital authorities to encouragestaff to attend meetings. While some DTCs areresponsible for the selection of medicines forthe hospital formulary, very few are involvedin monitoring medicines use or implementingstrategies to improve rational use.Meeting the challenges 2004-2007Over the next four years WHO will:> provide training, support, and advice tocountries seeking to establish and sustainfunctioning DCTs. This will involve regionaland international training courses as well astargeted support in response to requests fromcountries.> continue to support intervention researchprojects on promoting the rational useof medicines through DTCs and presentsome past results at the next internationalconference for improving the use ofmedicines.> ensure that future participants at internationalDTC courses are followed up more closelyat country level. Past experience has shownthat participants do not use the informationthey have learnt unless they have developeddefinite plans of action during the trainingcourses and have follow-up visits at countrylevel.OUTCOME INDICATORS1999 2003 2007No. of countries with DTCs in the majority of regions/provinces#REPORTING % TARGET#REPORTING % TARGETna na na 32/96 33% 40%
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