The decision to prescribe drugs is entirely based on medical principle and that drug treatment is an effective and safe treatment. The selection of these drugs is based on efficacy, safety, suitability, cost considerations and ensuring that no contraindications exist, minimal likelihood of adverse reaction and patient acceptability. Patients are to be provided with relevant, accurate, important and clear information regarding conditions and the medications prescribed, including the anticipated and unexpected effects of medications which are to be appropriately monitored.
Unfortunately, in real practice, prescribing patterns do not always conform to these criteria and this is what is classified as irrational prescription.
Common pattern of the irrational prescription may be manifested in the following forms:
Use of drugs when no drug therapy is indicated; for example, antibiotics for viral infections.
Use of wrong drug for a specific condition requiring drug therapy; for example, tetracycline in childhood diarrhea.
Use of correct drug with incorrect administration, dosage and duration; for example, the use of IV metronidazole, when suppository or oral formulations would be appropriate.
Use of unnecessary expensive drugs; for example, use of 3rd generation broad spectrum antimicrobial, when a first line narrow spectrum agent is indicated.
Other inappropriate prescription includes indiscriminate use of injections, multiple drug prescription, excessive use of antibiotics, minerals and tonic for malnutrition, self medication.
Factors that affect irrational use of drugs include the following:
Patient drug misinformation: that is, poor communication, misleading belief and patient demands/expectation.
Prescriber: wrong role models, lack of material safety data sheet (MSDS), absence of objective drug information, absence of education and training, generalization of limited experiences.
Work place: heavy patient load, pressure to prescribe, lack of adequate laboratory capacity, insufficient staffing etc.
Drug supply: unreliable supplier system, drug shortages, expire drug supplied.
Drug regulation: unavailability of essential drugs, non-formal prescribers, lack of regulation enforcement.
Industry: promotional activities and misleading assertions.
All these factors are affected by different characters that are rampant among the prescriber and user. The use of injections remains high now due to the false assumption of the prescriber that it will improve patients’ satisfaction and that they are anticipated by the patients.
The impact of this irrational drug use causes, reduction in the quality of drug therapy resulting in increased mortality and morbidity, waste of resources resulting in reduced availability of other important drugs and increased costs, high risk of undesirable effects like negative drug reactions and the emergence of drug resistance and lastly, psychological impact like when patients believe that there is a medicine for every sickness which may cause a seeming increased demand for drugs, also prolongation of illness, loss of patient confidence in health system.
Thus, rational use of drug is very important so as to limit undesired toxicity and adverse effect and maximize the benefits that can be derived from optional use of medications.
Therefore, patients are encouraged to always oblige to advice from healthcare professional, so as to interpret symptoms of an illness and the appropriate remedy.