(2002; 6 pages) [French] [Spanish]
The problem of irrational use
Irrational or non-rational use is the use of medicines in a way that is not compliant with rational use as defined above. Worldwide more than 50% of all medicines are prescribed, dispensed, or sold inappropriately, while 50% of patients fail to take them correctly. Moreover, about one-third of the world's population lacks access to essential medicines. Common types of irrational medicines use are:
• the use of too many medicines per patient (poly-pharmacy);
• inappropriate use of antimicrobials, often in inadequate dosage, 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, often of prescription-only medicines.
Lack of access to medicines and inappropriate doses result in serious morbidity and mortality, particularly for childhood infections and chronic diseases, such as hypertension, diabetes, epilepsy and mental disorders, Inappropriate use and over-use of medicines waste resources - often out-of-pocket payments by patients - and result in significant patient harm in terms of poor patient outcomes and adverse drug reactions. Furthermore, over-use of antimicrobials is leading to increased antimicrobial resistance and non-sterile injections to the transmission of hepatitis, HIV/AIDS and other blood-borne diseases, Finally, irrational over-use of medicines can stimulate inappropriate patient demand, and lead to reduced access and attendance rates due to medicine stock-outs and loss of patient confidence in the health system.