Ten recommendations to improve use of medicines in developing countries
Ten recommendations to improve use of medicines in developing countries
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DOI：
10.1093/heapol/16.1.13
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发表时间：
2001-03-01
影响因子：
3.2
通讯作者：
Ross-Degnan, D
中科院分区：
文献类型：
--
作者：
Laing, RO;Hogerzeil, HV;Ross-Degnan, D
不适当的处方会降低医疗质量，并导致资源浪费。为了解决这些问题，已经尝试了各种教育和行政方法来改善处方。本文回顾了过去十年的经验，以确定哪些干预措施已被证明是有效的，在发展中国家，并提出了一系列的政策选择，卫生规划人员和Manager.Considering的资源浪费在不适当地使用药物的规模，许多有前途的干预措施是相对便宜的。有一些简单的方法可以标准化地监测药物使用情况，并查明效率低下的情况。在某些情况下已证明有效的干预方法有：标准治疗指南;基本药物清单;药剂学和治疗学委员会;基于问题的基本专业培训;以及有针对性的卫生工作者在职培训。其他一些干预措施，如对贩毒者的培训、基于群体进程的教育和公共教育，需要进一步试验，但应得到支持。一些简单化的方法已被证明是无效的，例如仅以书面形式传播处方信息或临床指南。需要采取长期战略方针的两个问题是改善私营部门的处方和监测卫生部门改革的影响，现在已有足够的证据说服决策者，促进合理使用药物是可能的。如果遵循这些有效的战略，就可以提高保健质量，减少药品支出。
Inappropriate prescribing reduces the quality of medical care and leads to a waste of resources. To address these problems, a variety of educational and administrative approaches to improve prescribing have been tried. This article reviews the experiences of the last decade in order to identify which interventions have proven effective in developing countries, and suggests a range of policy options for health planners and managers.Considering the magnitude of resources that are wasted on inappropriately used drugs, many promising interventions are relatively inexpensive. Simple methods are available to monitor drug use in a standardized way and to identify inefficiencies. Intervention approaches that have proved effective in some settings are: sta nda rd treatment guidelines; essential drugs lists; pharmacy and therapeutics committees; problem-based basic professional training; and targeted in-service training of health workers. Some other interventions, such as training of drug sellers, education based on group processes and public education, need further testing, but should be supported. Several simplistic approaches have proven ineffective, such as disseminating prescribing information or clinical guidelines in written form only. Two issues that will require a long-term strategic approach are improving prescribing in the private sector and monitoring the impacts of health sector reform.Sufficient evidence is now available to persuade policy-makers that it is possible to promote rational drug use. if such effective strategies are followed, the quality of health care can be improved and drug expenditures reduced.