MeTA - Rational use of medicines

The rational use of medicines means that a patient takes the medicines appropriate to their clinical need, in suitable doses, for an adequate period of time and at the lowest cost to them and their community. But, the irrational use of medicines is widespread. Common problems include: the use of too many medicines per patient; the inappropriate use of anti-microbials for non-bacterial infections, and often in an inappropriate dosage; the over use of injections when oral formulations would be more appropriate; a failure to prescribe within clinical guidelines; and inappropriate self-medication, often of prescription-only medicines.

By working on different issues involved in increasing access to medicines and using a multi-stakeholder approach, the MeTA project will work towards improving the rational use of medicines.

We will add to this key list over time and would welcome suggestions or additions. Please send these to: sourceassistant@hi-uk.org

Selected resources

Community-based surveillance of antimicrobial use and resistance in resource-constrained settings|Report on five pilot projects

HOLLOWAY, Kathleen A
2009

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This document describes five pilot surveillance projects that were set up in India (three sites) and South Africa (two sites) with the aim of developing a model for undertaking integrated community-based surveillance in resource-constrained settings and generating baseline data. The methodology used in each area aimed to collect antimicrobial resistance (AMR) and use data from the same geographical area over time, but was modified to suit the particular characteristics of each site

Containing antimicrobial resistance

WORLD HEALTH ORGANIZATION (WHO)
April 2005

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The emergence of antimicrobial resistance is a natural phenomenon that follows use of antimicrobial drugs but it is being accelerated by inappropriate antimicrobial use. This leaflet considers various methods that can be used to help contain antimicrobial resistance

Drug and therapeutics committees : a practical guide

HOLLOWAY, Kathleen
GREEN, Terry
2003

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This guide provides guidance to doctors, pharmacists, hospital managers and other professionals who may be serving on Drug and Therapeutics Committees (DTCs) and/or who are concerned with how to improve the quality and cost efficiency of therapeutic care. It is relevant for all kinds of DTCs - whether in public or private hospitals and whether at district or tertiary referral level. This manual covers a committee's functions and structure, the medicines formulary process, and how to assess new medicines. The chapters on tools to investigate drug use and strategies to promote rational use are followed by a discussion of antimicrobial resistance and infection control. The publication concludes by explaining in detail how to start a committee or improve the effectiveness of an existing one

Fight AMR : save medicines for our children : call for action

ECUMENICAL PHARMACEUTICAL NETWORK (EPN)
2008

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This leaflet has been produced to raise awareness about antimicrobial resistance and possible areas of intervention including infection control, promoting effective diagnosis, improving prescribing practices and encouraging optimal use of antimicrobial agents. It is targeted at all the different groups of stakeholders who are in position to contribute to implementation of the containment actions that have been defined in the WHO Global Strategy for Containment of Antimicrobial Resistance

Ghana national drug policy

Ministry of Health, Ghana
2004

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This policy includes the following sections: a situational analysis of drug selection; drug procurement, storage and distribution; drug financing; quality assurance; local manufacture of pharmaceutical and traditional medicinal products; rational drug use; global trade and pharmaceuticals; emerging diseases and pharmaceuticals; human resource development for drug management; traditional medicinal products; research and development; and implementation of the policy

Guidelines for price discounts of single-source pharmaceuticals

WORLD HEALTH ORGANIZATION (WHO). Essential Drugs and Medicines Policy
et al
2003

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These guidelines are designed to maximise the benefit of price discounts arrangements for single-source products. They are intended for policy makers and technical staff in international and bilateral agencies active in international health development support, for pharmaeutical companies and for governments and NGOs in recipient countries. It highlights a number of issues that WHO feels need to be considered when planning or negotiating offers of price discounts

Guide to good prescribing : a practical manual

DE VRIES, T. P. G. M.
et al
1994

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This book provides step by step guidance to the process of rational prescribing, together with many illustrative examples. It teaches skills that are necessary throughout a clinical career. It is primarily intended for undergraduate medical students who are about to enter the clinical phase of their studies but postgraduate students and practicing doctors may also find it a source of new ideas

How to develop and implement a national drug policy

WORLD HEALTH ORGANIZATION
2001

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In this new edition guidelines are given on developing a national drug policy - a crucial ingredient in every country's national health strategy and an invaluable framework to identify national goals and commitments. This expanded and extensively revised second edition discusses key policy components. These include the selection of essential drugs, affordability , finance and supply, regulation and quality assurance, rational use, research, human resources, monitoring and evaluation.
Each chapter presents useful advice and references to other sources of more detailed technical information. A valuable resource for health professionals, policy-makers and researchers, the publication takes readers through the process of planning, developing, implementing and monitoring a comprehensive policy framework based on a country's unique needs, priorities and resources

Promoting safety of medicines for children

WORLD HEALTH ORGANIZATION
2007

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These guidelines are intended to improve awareness of medicine safety issues among everyone who has an interest in the safety of medicines in children and to provide guidance on effective systems for monitoring medicine safety in the paediatric populations. The document will be of interest to all healthcare professionals, medicine regulatory authorities, pharmacovigilance centres, academia, the pharmaceutical industry and policy-makers

Starting or strengthening a drug bulletin : a practical manual

INTERNATIONAL SOCIETY OF DRUG BULLETINS
WORLD HEALTH ORGANIZATION (WHO)
2005

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Access to independent and reliable drug information is key to the promotion of rational prescribing and use of medicines. Bulletins are essential tools for information dissemination and this manual aims to provide guidelines, tips and examples on how to start or improve drug bulletins. It covers all aspects of production, providing a comprehensive overview of the editorial process, the reviewing of new drugs and the design, production and distribution of the bulletin. The manual is an essential guide for anyone starting or running a drug bulletin, but may also be of interest to health professionals and others

The race against drug resistance : a report of the Center for Global Development’s drug resistance working group

NUGENT, Rachel
BLACK, Emma
BEITH, Alexandra
2010

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This report makes clear the need for urgent action to address the growing crisis of drug resistance. While there is no simple solution, there are achievable steps,that the health community, governments, donors, and the pharmaceutical industry can take to slow the spread of drug resistance. It says that retaining the medicines available now, developing new ones and other technology, and ensuring these resources continue to save lives in future generations must become a priority for global and national health organisations, both public and private

WHO global strategy for containment of antimicrobial resistance

WORLD HEALTH ORGANIZATION (WHO)
2001

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This strategy provides a framework of interventions to stimulate the prevention of infection, to slow the emergence of resistance and to reduce the spread of resistant microorganisms, in order to reduce the impact of resistance on health and health care costs, while improving access to existing agents and encouraging the development of new agents

Essentialdrugs.org

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This is the English language discussion group of essentialdrugs.org. Its objective is to support the concept of essential drugs by improving and speeding up communications among all health professionals working in the field of essential drugs. Discussions focus on topics such as rational use of drugs, drug policy, economics and financing, supply and marketing, legislation and regulation, quality assurance and safety, and training. E-drug is specifically targeted to health workers in developing countries, and is based on simple off-line e-mail technology. The site also has links to French, Spanish and Russian language discussion groups - E-MED, E-FARMACOS and E-LEK respectively, and to INDIA-DRUG, a national e-mail discussion group to foster rational use of drugs