who关于药物的常规使用（英文ppt）essential drug concept and the role of who in the promotion of rational drug use课件

DrJonathanDQuickDirector EssentialDrugsandMedicinesPolicyWorldHealthOrganizationInternationalPaediatricsAssociation September 2001 EssentialdrugconceptandtheroleofWHOinthepromotionofrationaldruguse Effectiveinterventions WHO srole Impactofirrationaluse EssentialdrugconceptandtheroleofWHOinthepromotionofrationaldruguse EssentialdrugconceptandtheroleofWHOinthepromotionofrationaldruguse WHOindicatorsofRDUdrugperencounters antibiotics injections Thenumberofdrugsperprescriptionvariesfrom1 3to4 3perprimarycareencounters Numberofdrugsperprescription Datefrom Quicketal 1997 ManagingDrugSupply Irrationaluse Over prescribingiscostly andspendingonchildhealthishighlycostsensitive Source Azerbaijan UNICEF BamakoTechnicalReportNo 35 Bangladesh1995 NationalAccounts1996 97Mali 1986 DiarraKandCoulibalyS FinancingofrecurrenthealthcostsinMali HealthPolicyandplanning 1990 5 2 126 138 Drugsarethelargesthealthexpenditureforpoorhouseholds Irrationaluse 30to60 ofPHCpatientstreatedwithantibiotics perhapstwicewhatisclinicallyneeded ofprimarycarepatientsreceivingantibiotics Datefrom Quicketal 1997 ManagingDrugSupply Irrationaluse Resistancetocommonpathogensiseverywhereontherise S pneumonia SummarizedbyWHO GPV Irrationaluse Upto56 ofprimarycarepatientsreceiveinjections over90 maybemedicallyunnecessary ofprimarycarepatientsreceivinginjections Chartdatefrom Quicketal 1997 ManagingDrugSupply 15billioninjectionsperyeargloballyhalfarewithunsterilizedneedleandsyringebyage2childreninsomecountrieshavereceivedupto20injections Irrationaluse Unsafeinjectionisamajorhealthhazard factorsareoveruseofinjections re usewithoutsterilisation contamination PopulationattributablefractionsSource Hauri Armstrong Hutin 2001 provisionalresult Infectionsattributabletounsafeinjection ofcases AnnualnumberPaediatric allages millions rates HepatitisB33 21 634 61 HepatitisC42 2 0upto68 HIV2 0 1 Irrationaluse Irrationaluseofdrugsisawidespreadhazardtohealth otherexamples 25 75 antibioticsinteachinghospitalsareinappropriateover2 3ofantibioticswithoutprescriptioninmanycountries90 ofconsumersbuy3 dayssupplyofantibioticsorlessprivateprovidersuse80differentTBregimens50 ofpeopleworldwidefailtotakemedicinescorrectly Irrationaluse EssentialdrugconceptandtheroleofWHOinthepromotionofrationaldruguse Standardtreatmentguidelines STGs reduceARImortalitywheneffectivelyimplemented Source WHO CDS CSR DRS 2001 9 Effectiveinterventions InjectionuseinIndonesiahasbeendramaticallyreducedthroughacombinationofinterventions Effectiveinterventions AntimalarialtreatmentinKenyahasbecomemorepromptandappropriatethroughshopkeepertraining Source Marshetal 2001 Effectiveinterventions Southernzone Northernzone Actionstoimproveuseofmedicines considereffectivenessandfeasibility HealthPolicy Planning 2001 RecommendedapproachesStandardtreatmentguidelinesEssentialdrugslistbasedontreatmentsofchoiceHospitalpharmacyandtherapeuticscommitteesProblem basedpharmacotherapytrainingProblem basedin serviceandcontinuingeducationPromisingapproachesInteractivegroupprocessamongprovidersandconsumersPharmacistanddrugsellertrainingConsumerinvolvementinpubliceducation Laingetal 2001 HealthPolicyandPlanning Effectiveinterventions EssentialdrugconceptandtheroleofWHOinthepromotionofrationaldruguse WHOModelListofEssentialDrugs11thmodellist306drugs Modernizingtheessentialdrugsconcept CreatingaWHOEssentialDrugsLibrary TheGuidetoGoodPrescribing widelyappliedtoolfordevelopingsystematicprescribingpractices addressedarealneedtrainingingoodprescribingbasedinaWHOcollaboratingcentredevelopedthroughaparticipatoryprocessprofessionalsfrom30countries 15WHOofficesfield testedin7countrieswidelypublicized activelyfollowed uptranslationinto18languagesadoptedbyteachinginstitutionsworldwidetrainingteachers WWW adaptation WHO srole Promotingrationaldruguse INRUD WHO MSH regionalcoursesAfrica Asia LatinAmerica Promotingrationaldruguse WHOguidelines training informationsupport someexamples WHOmodelformularyandmodelprescribinginformation activerolesforallstakeholders WHO srole Ethicalcriteriaformedicinaldrugpromotion truthfulnessinallpromotionalactivities Globalstrategyforcontainingantimicrobialresistance activerolesforallstakeholders Monographsonselectedmedicinalplants information evidenceonavailability efficacy safety ExpandingaccesstoWHOinformationhttp www who int medicines WHO srole WHOsupportscountries professionalbodies NGOs guidelines training information technicalsupport Effectiveinterven