How You Should Prescribe According To W.H.O Guidelines

Rational prescribing is a mean of safe and effective therapeutic outcomes with least adverse effects. But this is not in practice in most parts of the world. To encourage rational prescribing WHO conveyed a conference at Nairobi in 1985 and formulate a set of indicators to evaluate the prescribing pattern at health settings. The indicators were established to find mean of polypharmacy, generic prescribing, prescribing from EML, prescribing of

Antibiotics, Supplements and costly dosage form of Injectibles and mean cost of prescriptions dispensed.Rational use of medicines requires that "patients receive medications 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"

Irrational or non-rational use is the use of medicines in a way that is not compliant with rational use. 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 worlds 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.

The Prescribing Indicators, developed by WHO and International Network for Rational Use of Drugs (INRUD) includes,

1. Average numbers of drugs per prescriptions

2. Percentage of drugs prescribed by Generic name

3. Percentage of drugs prescribed from Antibiotics

4. Percentage of drugs prescribed as Injectibles

5. Percentage of drugs prescribed from supplements

6. Percentage of drugs prescribed from Essential Medicines List (EML)

7. Average cost of the prescriptions prescribed

The average number of drugs per prescription should be reduced to overcome Polypharmacy as it increases chances of drug interactions and resistance, affect patient compliance and elevates cost of therapy. The generic prescribing and prescribing from EML is a major concern and prescribers should Know and made aware to prescribe more as generic and from EML.