Abstract
In this article the authors deal with issues of drug utilisation from a clinical and policy perspective. They address the difficulties of managing drug therapy on a population level, which is known among professionals, as the problem of rational use of medicines. Various definitions and interpretations are presented and compared. This is followed by a presentation of the concerns associated with pharmaceutical marketing from a policy perspective, including the fear that the dominance of information produced by industry may lead to irrational drug use. Next, the authors review the tools for policy making including educational, managerial, and regulatory interventions. The (often overlapping) concepts of medicines management, clinical pharmacy and pharmaceutical care are then discussed to show how professionals, sometimes in collaboration with policymakers, have tackled the problem of nonrational use of medicines. The authors address the question as to whether the rational use of medicines a universal concept, whether it can be and whether it should be? They argue that, as with most concepts, the rational use of medicines must always be viewed in context. They conclude that pharmacy needs to adapt its way of thinking to include the issue of context. They point out that clinical pharmacists today already adapt their decisons to each patient and patient group. Policymakers are encouraged to adopt a similar approach because populations as well as particular market situations vary and therefore policy solutions cannot be considered universal.
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References
D Jary J. Jary (1991) Collins Dictionary of Sociology Harper Collins Publishers Glasgow
InstitutionalAuthorNameWorld Health Organization (2001) How to develop and implement a national drug policy EditionNumber2 World Health Organization Geneva 59–68
G. Loewenstein (2004) ArticleTitleDoctors and drug companies N Engl J Med. 351 IssueID18 1885–90 Occurrence Handle10.1056/NEJMhpr042734 Occurrence Handle15509823
LD Spiller WW. Wymer (2001) ArticleTitlePhysicians’ perceptions and uses of commercial drug information sources: an examination of pharmaceutical marketing to physicians Health Mark Q. 19 IssueID1 91–106 Occurrence Handle10.1300/J026v19n01_07 Occurrence Handle1:STN:280:DC%2BD3MnotFKrsA%3D%3D Occurrence Handle11727295
D Armstrong H Reyburn R. Jones (1996) ArticleTitleA study of general practitioners’ reasons for changing their prescribing behaviour BMJ. 312 IssueID7036 949–52 Occurrence Handle1:STN:280:BymC1Mnms1I%3D Occurrence Handle8616310
MI Jones SM Greenfield CP. Bradley (2001) ArticleTitlePrescribing new drugs: qualitative study of influences on consultants and general practitioners BMJ. 323 IssueID7309 378–81 Occurrence Handle10.1136/bmj.323.7309.378 Occurrence Handle1:STN:280:DC%2BD3MvmsVemtw%3D%3D Occurrence Handle11509431
J Avorn M Chen R. Hartley (1982) ArticleTitleScientific versus commercial sources of influence on the prescribing behavior of physicians Am J Med. 1982 IssueID73(1 4–8 Occurrence Handle10.1016/0002-9343(82)90911-1
A. Wazana (2000) ArticleTitlePhysicians and the pharmaceutical industry: is a gift ever just a gift? JAMA. 283 IssueID3 373–80 Occurrence Handle10.1001/jama.283.3.373 Occurrence Handle1:STN:280:DC%2BD3c7ht1ehtQ%3D%3D Occurrence Handle10647801
B Mintzes ML Barer RL Kravitz K Bassett J Lexchin A Kazanjian RG Evans R Pan SA. Marion (2003) ArticleTitleHow does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA CMAJ. 169 IssueID5 405–12 Occurrence Handle12952801
Kaiser Family Foundation. National Survey of Physicians Part II: Doctors and Prescription Drugs, 2002. http://www.kff.org/rxdrugs(20020415b-index.cfm
Kaiser Family Foundation. Understanding the Effects of Direct-to-Consumer Prescription Drug Advertising, 2001. http://www.kff.org/rxdrugs/3197-index.cfm
Anon. Medicines management services – why are they so important? MeReC Bulletin (National Prescribing Centre NHS) 2002; 12(6)
The Audit Commission. A Spoonful of Sugar – Medicines Management in NHS Hospitals. London: The Audit Commission, 2001. http://www.audit-commission.gov.uk/Products/NATIONAL-REPORT/E83C8921-6CEA-4b2c-83E7-F80954A80F85/ nrspoonfulsugar.pdf
N. Barber (2001) ArticleTitlePharmaceutical care and medicines management – is there a difference? Pharm World Sci. 23 IssueID6 210–11 Occurrence Handle10.1023/A:1014566710612 Occurrence Handle1:STN:280:DC%2BD38%2Fpslahsw%3D%3D Occurrence Handle11826509
ESCP. What is clinical pharmacy? http://www.escpweb.org/site/cms/contentViewArticle.asp?article=1712 (accessed 22 November 2004)
ACCP. Defining Clinical Pharmacy. The ACCP Report 23(2). February 2004. http://www.accp.com/report/rpt0204/art 01.php
RL Mikeal TP Brown HL Lazarus MC. Vinson (1975) ArticleTitleQuality of pharmaceutical care in hospitals Am J Hosp Pharm. 3 567–74
DC Brodie PA Parish JW. Poston (1980) ArticleTitleSocietal needs for drugs and drug-related services Am J Pharm Educ. 44 276–78 Occurrence Handle1:STN:280:Bi6D3sjgvVQ%3D Occurrence Handle10317016
CD Hepler LM. Strand (1990) ArticleTitleOpportunities and responsibilities in pharmaceutical care Am J Hosp Pharm. 47 533–43 Occurrence Handle1:STN:280:By%2BC1MngtlU%3D Occurrence Handle2316538
RJ Cipolle LM Strand PC. Morley (2004) Pharmaceutical care practice – the clinician’s guide EditionNumber2 McGraw-Hill New York
van Mil JWF. Pharmaceutical care – the future of pharmacy. Thesis, Chapter 1. Rijksuniveriteit Groningen, 1998
Munroe WP, Dalmady-Israel C. (1998). The community pharmacist’s role in disease management and managed care. Int Pharm J. 12(Suppl II)
PP. Rioux (2000) ArticleTitleClinical trials in pharmacogenetics and pharmacogenomics: methods and applications Am J Health Syst Pharm. 57 887–901 Occurrence Handle1:CAS:528:DC%2BD3cXjtl2nsLw%3D Occurrence Handle10840530
R. March (2000) ArticleTitlePharmacogenomics: the genomics of drug response Yeast. 17 16–21 Occurrence Handle10.1002/(SICI)1097-0061(200004)17:1<16::AID-YEA6>3.0.CO;2-E Occurrence Handle1:CAS:528:DC%2BD3cXkt1ejs7Y%3D Occurrence Handle10797598
C Condit A Templeton BR Bates JL Bevan TM. Harris (2003) ArticleTitleAttitudinal barriers to delivery of race-targeted pharmacogenomics among informed lay persons Genet Med. 5 IssueID5 385–92 Occurrence Handle14501834
AB Almarsdóttir I Björnsdóttir JM. Traulsen (2005) ArticleTitleA lay prescription for tailor-made drugs – focus group reflections on pharmacogenomics Health Policy. 71 233–41 Occurrence Handle10.1016/j.healthpol.2004.08.010 Occurrence Handle15607385
F. Lichtenberg (1996) ArticleTitleDo (more and better) drugs keep people out of hospitals? Am Econ Rev. 86 IssueID2 384–8 Occurrence Handle1:STN:280:BymE3MvmtFY%3D Occurrence Handle10172775
DM Cutler M. McClellan (2001) ArticleTitleIs technological change in medicine worth it? Health Aff. 20 IssueID5 11–30
G Ragnarson Tennvall G. Karlson (1998) ArticleTitleCancer treatment in Sweden – costs of drugs, inpatient and outpatient care from 1985 to 1996 and cost effectiveness of new drugs Acta Oncol. 37 IssueID5 447–53 Occurrence Handle10.1080/028418698430395 Occurrence Handle1:STN:280:DyaK1M%2Fkslalug%3D%3D Occurrence Handle9831373
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*This article is the second in a series of articles on this topic that will appear in Pharmacy World & Science during 2005.
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Almarsdóttir, A.B., Traulsen, J.M. Rational use of medicines – an important issue in pharmaceutical policy. Pharm World Sci 27, 76–80 (2005). https://doi.org/10.1007/s11096-005-3303-7
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DOI: https://doi.org/10.1007/s11096-005-3303-7