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1.
Role of WHO in RUD

1.1. Define the rational drug use
1.2. Region wise office
1.3. Drug use indicators
1.4. Recommendations on RUD
1.5. Introduced the courses for training on RUD
1.6. Address industry power
2. Role of Government in RUD

2.1. Establishment of regulatory authority to co-ordinate legislation about
medicines
There are different factors participating their role in use of medicines. Therefore, it is necessary
to make a national regulating authority that make new laws about medicine use and also
encourage their implementation in the society. This regulatory body should discuss its policies
and programs with other shareholder of the society, not only in public but also in private sector.
2a In Pakistan, this regulatory body is DRAP; Drug regulatory authority of Pakistan. DRAP
make different laws about the rational use of medicine but the implementation of these rules is
need of hour.
2.2. Establishment of Pharmacovigilance department
Pharmacovigilance includes the study of safety of different medicines when these medicines are
marketed. Mainly the side effects of medicines are studied. After the incidence of thalidomide
induced adverse effects, regulatory bodies pay special attention towards this aspect of medicines.
3d Government should establish adverse drug reaction reporting systems but unfortunately,
Pakistan lack in this perspective. According to a study, 71.8% healthcare givers think that ADRs
are not reported due to shortage of assets and little number of capable pharmacists. 2b
2.3. Education of policy makers
For the enforcement of any policy or rule in a society, it is essential to educate the policy makers
and planners about its importance. Its implementation will also be affected by the politician’s
interest in it. They should be consulted during different meetings related to health issues. It is
worthy to make an effective and short presentation on rational use of medicine and present it in
front of ministry of health officers. Government can also promote it by announcing to celebrate a
“national day of rational drug use.”
2.4. Sponsorship and lobbying
The government should involve all the groups involved in manufacturing, legislating, promoting
and using the medicines. When different people have same mission, they can work in an
effective manner by making and implementing different policies related to rational use of
medicines. 2a
2.5. Research institutes establishment
Medical profession is multi-disciplinary in nature because of wide range of therapeutic gears
(drugs) in healthcare system. Research is necessary in this field due to growing need of health
related issues. Government should establish different research institutes and labs for this purpose.
Research can be initiated to take out another indication of a previous drug or to improve the
therapeutic technique. 3b
3. Role of Pharmacist in RUD

3.1. Rational prescribing
Medicines are prescribed in healthcare system to treat a patient illness. On one side where
medication treats a disease, they can also cause harm in toxic concentration. It is necessary to
practice rational use of medicine. A prescriber must follow four objectives for prescribing:
 Enhance the therapeutic effectiveness
 Reduce the hazards
 Manage the costs
 Admiration of patient preferences 3d
The interventions made by pharmacist in prescriptions of patients with polypharmacy reduced
the medication errors and improve their quality of life of patients. 3e
Irrational prescribing leads to wastage of assets and harm to patient health. 3d
3.2. Medication adherence awareness
Medication adherence is the degree to which a patient takes its medicines effectively. Non
adherence can be categorized into two types; intentional or unintentional. Non-adherence to
medication therapy can leads to serious consequences e.g morbidity or mortality. 3d
There are different factors responsible for non-adherence to medication e.g age, race,
polypharmacy, lack of knowledge and cost.3f The pharmacist should explain the risks and
benefits of not taking medicines to patient. He also address about the factor contributing toward
the non-adherence to promote the rational use of medicine. 3d A pharmacist can use different
medical aids e.g drug reminder charts or medication calendars to attain escalating outcomes in
management of a disease.
3.3. Drug utilization review
Drug utilization review is a legal and continuing system which reviews the prescribing habits of
doctors, dispensing habits of pharmacist and medicines used by patients. DUR studies are result
of an increasing emphasize of legal authorities to develop clinical guidelines on rational use of
medicines. 3c Pharmacist as a member of DUR system can help to identify the complications
associated with drug use and can also minimize the adverse reactions. DUR studies evaluate the
usage criteria of different type of pharmacotherapies and then collect data on it, after that this
data is analyzed to advance the appropriate use of drugs. 3b Although, the reputation of DUR
system is not appreciated by our society due to limited knowledge, resources and its outcomes.
3c
3.4. Pharmacy and therapeutic committee (P&TC)

Pharmacist as a member of this committee can work to promote the rationale use of medicine by
taking following steps:
 Hospital formulary running
 Generic based selection of drugs
 Reporting adverse effects of medicines
 Making strategy for controlled drugs
 Participating in drug research
 Participating in drug utilization review 3b
3.5. Patient Counseling

In patient counseling a pharmacist give information to patient related to correct use of a
medicine. The worthy outcomes of medication therapy can be achieved by counseling the
patient. 3a The pharmacist can utilize the both active (oral instructions) and passive (printed or
visual material) mode of counseling. 3b For the verification that a patient completely understand
that how to use the prescribed medicine, the pharmacist should ask different questions from
patient. Patient counseling not only boosted the compliance of patient but also the rationale use
of medicine.3a

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1.

Role of WHO in RUD

2. Role of Government in RUD

3. Role of Pharmacist in RUD

3.4. Pharmacy and therapeutic committee (P&TC)

3.5. Patient Counseling

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