DNA India
05 June 2010
By Vineeta Pandey
New Delhi, India

Are you being prescribed too many medicines? Are you getting injections for drugs whose oral formulations are available? Are you indulging in self–medication? Are you among those who do not adhere to doses, particularly of antimicrobials?

If the answers are ‘yes’, you may be a victim of“irrational use of medicines”.

A World Health Organisation (WHO) report says more than 50% of medicines are prescribed, dispensed or sold inappropriately.

Half the patients in the world fail to take medicines correctly. This incorrect use may take the form of overuse, under–use or misuse of prescription or non–prescription medicines.

The report says in developing countries, the proportion of patients treated according to clinical guidelines for common diseases in primary care is less than 40% in the public sector and 30% in the private sector. Less than 60% of children with acute diarrhoea receive necessary oral rehydration therapy and more than 40% receive unnecessary antibiotics.

Only 50% of people with malaria receive the recommended first–line antidote. Only 50–70% of people with pneumonia are treated with appropriate antibiotics and up to 60% with viral upper respiratory tract infections receive antibiotics inappropriately.

Medical experts say it’s a huge problem.“A committee set up by the drug controller general of India some years ago tried to weed out irrational use of medicines. Baralgan, used for abdominal pain, was a combination of three medicines, of which the committee removed two to prevent its irrational use.

Similarly, Streptomycin was sold with penicillin. Though it was meant for tuberculosis, it was used widely for many other infections since it was cheap. The committee broke the combo,” Anoop Misra, director of metabolic diseases at the Delhi–based Fortis Hospital, said.

He said very few doctors cut out unnecessary drugs from prescriptions.“If a doctor writes only one medicine, patients sometimes feel he is not knowledgeable. Illiterate patients who buy over–the–counter medicines without prescription too are responsible for irrational use,” Misra said.

According to WHO, examples of irrational use of medicines include use of too many medicines per patient, inappropriate use of antimicrobials often in inadequate doses for non–bacterial infections, overuse of injections when oral formulations are more appropriate, failure to prescribe in accordance with clinical guidelines, inappropriate self–medication, often of prescription–only medicines and non–adherence to doses.

WHO says incorrect use of medicines was prevalent worldwide, causing harm to people and wasting resources.

Its consequences include antimicrobial resistance due to overuse of antibiotics, making medicines ineffective against infectious disease, and adverse drug reactions and medication errors.