ROLE OF UCG IN

APPROPRIATE MEDICINE
USE

Appropriate Medicine Use unit

Pharmacy Department
October 2017
 DEFINITION  
q Pa#ents  receive  medica/ons    
⇒  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, 1985)

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 Inappropriate  medicine  use  
q Inadequate  diagnosis    
q Inadequate  prescribing  
⇒  Non adherence to standard guidelines
⇒  Poly-pharmacy, wrong doses/route/duration
⇒  Expensive/un-necessary medications
q Inadequate  dispensing/administra#on  
⇒  Wrong incomplete labelling, instructions, etc
q Inadequate  adherence/incorrect  use  in  the  
community  
⇒  Wrong dose/duration
⇒  Incomplete doses
⇒  Self medication
⇒  Questionable quality medicines 3  
 Factors  affec/ng  medicine  use  
category   Factors  
Health  workers’   Training,  CMEs,    experience,  peer  
factors   pressure,  authority  and  supervision  
System  factors   Workload,  infrastructure,  
laboratory,  organiza#on  of  work  
Supply  chain   Availability  of  medicines,  quality  of  
medicines,    
Pa#ents’  factor   Pa#ents’  demands,  socio  cultural  
factors  
Other  eternal   Industry  pressure,  drug  
factors   informa#on,  financial  incen#ves,  
regulatory  framework   4  
 Consequences  of  inappropriate  use  

Reduced   MORTALITY  
quality  of  
therapy   MORBIDITY  

Inappropriate   Reduced  availability  of  

use  of   Waste  of   medicines  
medicines   resources  
INCREASED  COST  

Risk  of   Adverse  reac/ons  

unwanted  
effects   BACTERIAL  
RESISTANCE  
Psychosocial   Pa/ents  rely  on  
5   impacts   unnecessary  medicine  
 World  situa/on  
q Irra#onal  use  of  medicines  is  a  major  problem  
worldwide.  WHO  es#mates  that  more  than  half  
of  all  medicines  are  prescribed,  dispensed  or  
sold  inappropriately,  and  that  half  of  all  
pa#ents  fail  to  take  them  correctly.  
 =  only  25%  of  the  medicines  are  used  
appropriately!!!      

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 The  problem  in  summary  
q Inappropriate  medicine  management  and  use  
causes:  
⇒  Adverse clinical outcomes
⇒  Waste of resources

LOW QUALITY,
LOW COST EFFECTIVENESS,
LOW EFFICIENCY
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 Uganda’s  situa/on    
WORLD  BANK  REPORT  2013   Inappropriate    
treatment  
 
64%  
42%  

Inappropriate    
diagnosis  
  WHO  INTERVENTIONS  

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  UCG  and  EMHSLU  
 
 
 

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  PROCESS  
LIST  OF  COMMON  DISEASES  AND  COMPLAINTS  

TREATMENT  CHOICE  

TREATMENT     ESSENTIAL   MEDICINE/

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GUIDELINES   SUPPLIES    LIST    

TREATMENT,  TRAINING     SUPPLY  

AND  SUPERVISION  
  PRINCIPLES  

•  SELECTION  OF    
       PRIORITY    
       CONDITIONS  

•  SCIENTIFIC  EVIDENCE,  
•  COST  EFFECTIVENESS,    
•  IMPLEMENTABILITY  

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 LIMITATIONS  
q NOT  A  COOK  BOOK  
⇒  Does not have all the answers
⇒  Clinical judgement still applies!

q NOT  A  TEXTBOOK    
⇒  It has mainly common conditions
⇒  For primary care (not specialist)

q NOT  A  FIXED  REGULATION  

⇒  Can become outdated
and inaccurate
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  CONCLUSION  
q Standard  treatment  guidelines  are  an  essen#al  
tool  to  promote  appropriate  medicine  use,  and  
⇒  Improve quality of care
⇒  Improve use of resources
q If  they  are  used  to  guide  
⇒  Treatment
⇒  Training
⇒  Supervision
⇒  Procurement/supply

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