Assessing irrational medicine use in community pharmacies: A case study in Kawempe Division, Kampala.

Abstract

Irrational medicine use remains a major global health problem which mostly affects developing countries. The World Health Organization (WHO) estimates that more than half of all medicines are inappropriately prescribed, dispensed, or sold. And additionally, around 50% of patients fail to take their medicines correctly (WHO). It is estimated that 60% of medicines in public health facilities and 70% of medicines in private facilities were prescribed and sold inappropriately in developing countries (Mao et al., 2015). In 1985, the WHO convened a meeting of experts on the rational use of drugs, in which the rational use of medicine was defined as a situation where a patient receives medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community (WHO). Irrational use of drugs is most certainly the opposite of rational drug use. Irrational use of medicines includes: use of too many medicines per patient i.e. poly-pharmacy, inappropriate use of antimicrobials; either in inadequate dosage or for non-bacterial infections, over-use of injections when oral formulations would be more appropriate, failure to prescribe in accordance with clinical guidelines, inappropriate self-medication and non-adherence to dosing regimens (WHO). The irrational use of drugs can be caused by economic, cultural and structural factors (Lukali & Michelo, 2015). Economic factors would include the price of the drug, the purchaser's financial means and financial incentives given to prescribers. Structural factors like the health systems, which includes stock levels, availability of inappropriate drugs, expired drugs, and unreliable supply are all involved in the therapeutic process and can contribute to irrational drug use in a number of ways (Quick et al., 1997).