How to promote rational use of drug in drugstore?

The definition

The rational use of drugs requires that patients receive receive medications appropriate to their clinical needs,
in needs, in doses that meet their own individual requirements for an adequate period of time, and at the and
at the lowest cost to them and their community.(WHO 1985)

The promotion for irrational drug use

Polypharmacy

The multiple drugs often termed polypharmacy commonly defined as 5-10 drugs use per prescription. The
community pharmacies have the important role to manage patient drugs. The multiple drugs can lead to the
drug interaction, disrupted drug metabolism and adverse drug reaction occurred.

The step to manage polypharmacy

1. Prevention the pharmacist not prescribes the unnecessary drugs, non-approved drugs or the drug that low
evidence to therapeutic uses.

2. Regular medication review the pharmacist should be reviewing the multiple drugs for the patient; in term
of indication, dose regimen drug interaction and possible adverse drug event. The accurate history use for
multiple drugs is needed. Ask the patient to bring the old drugs (prescription drug& non-perception drug)

3. Non-pharmacological approach concern with the life style measure before added new drugs or switch drugs

4. Communication discuss with patient about the expectation the satisfaction of the drug therapy ,the patient
compliance is needed ,the patient have to clarify the drug use ,remember time to take the drugs. Pharmacist
will be talk with their doctor or health care giver when needed to change the medication.

5. Simplify the pharmacist chooses the appropriate regimen for patient, consider as fewest dosage intervals,
and reduce the unnecessary drug as possible.

Inappropriate self-medication

self-medication is associated with risks such as misdiagnosis, use of excessive drug dosage, prolonged duration
of use, drug interactions and polypharmacy. The latter may be particularly problematic in the elderly.
Monitoring systems, a partnership between patients, physicians and pharmacists and the provision of
education and information to all concerned on safe self-medication, are proposed strategies for maximizing
benefit and minimizing risk.
Role of pharmacist in self-medication

As a communicator

1. The pharmacist should initiate dialogue with the patient to obtain a sufficiently detailed medication
history.
2. In order to address the condition of the patient appropriately the pharmacist must ask the patient key
questions and pass on relevant information to him or her.
3. The pharmacist must be prepared and adequately equipped to perform a proper screening for
specific conditions and diseases, without interfering with the prescribers authority.
4. the pharmacist must provide objective information about medicines.
5. The pharmacist must be able to use and interpret additional sources of information to satisfy the
needs of the patient.

As a quality drug supplier

1. The pharmacist must ensure that the products he/she purchases are from reputable sources and of
good quality.
2. The pharmacist must ensure the proper storage of these products.

As a trainer and supervisor

1. The pharmacist is assisted by non-pharmacist staff and must ensure that the services rendered by
these auxiliaries correspond to established standards of practice.
2. The pharmacist must promote the training and supervise the work of non-pharmacist staff.

As collaborator

The pharmacist need to develop the quality collaborative relationships with other health care professionals,
national professional associations etc.

As health promoter

1. Participate in health screening to identify health problems and those at risk in the community.
2. Participate in health promotion campaigns to raise awareness of health issues and disease
prevention.
3. Provide advice to individuals to help them make informed health choices.

References

1. World Health Organization (2002) Promoting Rational Use of Medicines: Core Components - WHO Policy
Perspectives on Medicines, No. 005

2. World Health Organization (1998) the Role of the Pharmacist in Self-Care and Self-Medication. Report of the
4th WHO Consultative Group on the Role of the Pharmacist .The Hague, The Netherlands

3. What is polypharmacy? Steps for managing polypharmacy in elderly patients National Prescribing Service
Newsletter; 2000