1,837,974 research outputs found
National OTC medicines programme
Get PDFIn 2012, Fimea was entrusted by the Ministry of Social Affairs and Health with the task of
formulating a national OTC medicines programme. The programme delineates the objectives of and prerequisites for Finnish over-the-counter (OTC) medicines and discusses factors influencing the OTC medicine selection. Key stakeholder views have been sought in the preparatory stages.
The national OTC medicines programme lays down the related principles. The programme
does not deal with the entirety of self-care, but focuses on the possibilities offered by medicinal products with a marketing authorisation as a component of self-care. The programme describes the factors guiding the OTC medicine selection and provides pharmaceutical industry stakeholders with assistance in understanding the marketing authorisation process. A survey of OTC medicine users in 2013 served as a backdrop for the programme.
In OTC medicine, some responsibility is transferred to the medicine user. In addition to a
suitable OTC medicine selection, adequate advice and guidance are needed alongside the management of the user's overall medication, in support of successful therapy. The Finnish professional pharmacy system affords an excellent setting for providing counselling, but further work is needed on improving and harmonising such counselling. All stakeholders in the field play a role in providing medicines information, and counselling could be further improved by intensifying co-operation. Not enough research is available on the effects of OTC medicine on people's health behaviour, on the use of health services and on the possible reduction of the load on health care in Finland.
In terms of public health, the availability of OTC medicines in Finland is good in regard to
time, location and selection. To ensure the effectiveness of health care, there may be a
need to broaden the selection of OTC medicines in the market, but this must be effected in a controlled and safe manner. In this connection, it must be ensured that the products proposed for OTC care meet the criteria set for them within the programme. When a product is accepted as an OTC medicine, safety may in some cases be ensured by granting initially an OTC license only for a limited period, or by requiring that additional advice is given when dispensing the product. Harmonisation of the selection of OTC medicines within the EU is not an end in itself, but must take account of the variety of health care systems within the member countries.
As a follow-up to the OTC medicines programme, strong co-operation in developing the implementation of OTC medicine is expected from stakeholders in the Finnish pharmaceutical sector. Fimea can serve as a coordinator of such co-operation, but all stakeholders are expected to play both an active and proactive role.Published also in Finnish and Swedis
Medicines Information Services: Current State and the Strategy for 2020
Get PDFRATIONAL USE OF MEDICINES THROUGH INFORMATION AND GUIDANCE. Vision: Finland will have in place a multidisciplinary national network of pharmaceutical sector stakeholders to produce and disseminate evidence-based, objective and reliable information to healthcare professionals and the public. Mission: Medicines information promotes the rational use of medicines among the population and thus maintains and improves the health of the Finnish population
Can NGOs Regulate Medicines Markets? Social Enterprise in Wholesaling, and Access to Essential Medicines.
Get PDFCitizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action
New Ways of Working – Pharmacy and Medicines Management
No full textMedicines play a key role in the treatment of most mental illnesses. The management of those medicines is of great importance to most mental health service users and also impacts on the daily professional life of many of those involved in caring, be they psychiatrists, nurses, pharmacists or others.
The New Ways of Working (NWW) project began with a study of the potential to devolve many of the aspects of the dispensing of medicines within pharmacy departments from pharmacists to pharmacy technicians and then to pharmacy assistants. As this project evolved it became clear that perhaps the greatest impact of pharmacy staff and potential for NWW of medicines management was not just in the dispensary but within teams and wards. As further projects began to identify the potential for pharmacy staff to improve the way medicines are used across the whole spectrum of clinical care, it also became clear that medicines management and pharmacy had for many years been an area of neglect by Mental Health Trusts (MHTs) and for many to achieve safe and effective medicines use, would require significant investment. By the end of the programme a wide range of products associated with medicines management, involving pharmacy, service users, carers and others, had been developed (www.newwaysofworking.org.uk)
Quality control of herbal medicines
Get PDFDifferent chromatographic and electrophoretic techniques commonly used in the instrumental inspection of herbal medicines (HM) are first comprehensively reviewed. Chemical fingerprints obtained by chromatographic and electrophoretic techniques, especially by hyphenated chromatographies, are strongly recommended for the purpose of quality control of herbal medicines, since they might represent appropriately the "chemical integrities" of the herbal medicines and therefore be used for authentication and identification of the herbal products. Based on the conception of phytoequivalence, the chromatographic fingerprints of herbal medicines could be utilized for addressing the problem of quality control of herbal medicines. Several novel chemometric methods for evaluating the fingerprints of herbal products, such as the method based on information theory, similarity estimation, chemical pattern recognition, spectral correlative chromatogram (SCC), multivariate resolution, etc. are discussed in detail with examples, which showed that the combination of chromatographic fingerprints of herbal medicines and the chemometric evaluation might be a powerful tool for quality control of herbal products
Issues potentially affecting quality of life arising from long-term medicines use: a qualitative study
Get PDFBackground Polypharmacy is increasing and managing large number of medicines may create a burden for patients. Many patients have negative views of medicines and their use can adversely affect quality of life. No studies have specifically explored the impact of general long-term medicines use on quality of life. Objective To determine the issues which patients taking long-term medicines consider affect their day-to-day lives, including quality of life. Setting Four primary care general practices in North West England Methods Face-to-face interviews with adults living at home, prescribed four or more regular medicines for at least 1 year. Interviewees were identified from primary care medical records and purposively selected to ensure different types of medicines use. Interviews were recorded, transcribed and analysed thematically. Results Twenty-one interviews were conducted and analysed. Patients used an average of 7.8 medicines, 51 % were preventive, 40 % for symptom relief and 9 % treatment. Eight themes emerged: relationships with health professionals, practicalities, information, efficacy, side effects, attitudes, impact and control. Ability to discuss medicines with health professionals varied and many views were coloured by negative experiences, mainly with doctors. All interviewees had developed routines for using multiple medicines, some requiring considerable effort. Few felt able to exert control over medicines routines specified by health professionals. Over half sought additional information about medicines whereas others avoided this, trusting in doctors to guide their medicines use. Patients recognised their inability to assess efficacy for many medicines, notably those used for prophylaxis. All were concerned about possible side effects and some had poor experiences of discussing concerns with doctors. Medicines led to restrictions on social activities and personal life to the extent that, for some, life can revolve around medicines. Conclusion There is a multiplicity and complexity of issues surrounding medicines use, which impact on day-to-day lives for patients with long-term conditions. While most patients adapt to long-term medicines use, others did so at some cost to their quality of life
RACE AGAINST TIME: THE EXPORT OF ESSENTIAL MEDICINES TO RWANDA
No full textDR MATTHEW RIMMER* This article considers the significance of the first export of essential medicines under the WTO General Council Decision 2003. In July 2007, Rwanda became the first country to provide a notification under the WTO General Council Decision 2003 of its intent to import a fixed-dose, triple combination HIV/AIDS drug manufactured by the Canadian generic pharmaceutical manufacturer, Apotex Inc. In September 2007, Apotex was granted the first compulsory licence application under Canada’s Access to Medicines Regime. This article considers the convoluted and protracted negotiations between the Government of Rwanda, Apotex, and three patent holders, GlaxoSmithKline, Boehringer Ingleheim Canada and Shire BioChemical Inc. It questions the efficiency of this process. This article considers the review of the Jean Chrétien Pledge to Africa Act 2004 (Canada). It is critical of the refusal of the Conservative Government of Canada to make any amendments to the legislation to improve the cost-effective delivery of essential medicines. This article queries the proposed Hong Kong Amendment to the TRIPS Agreement 1994, given the concerns of the Africa Group. It is submitted that it is undesirable to codify the WTO General Council Decision 2003, given its failure to provide a speedy
Assessment of Availability, Affordability and Prescribing Patterns of Essential Medicines in Public Health Facilities in Tanga Region, Tanzani
Get PDFTo determine and assess the availability, affordability and prescribing pattern of essential medicines in public health of Tanzania. Setting: Availability, affordability, and rational use of medicines were assessed in primary health care centers in six different geographical areas of Tanga region. This was a cross-sectional survey in accordance with the WHO guidelines for monitoring and assessing the pharmaceutical situation in developing countries, which was conducted between May and June 2011 in Tanga. For this survey, a total of 30 public health facilities were selected from the six different geographic areas identified in Tanga and 600 clients were interviewed during the study. The mean average number of medicines prescribed by physician was 2.9 per prescription. The number of prescriptions containing an antibiotic was 66.61% on average. The number of prescriptions containing injectable medicines was 25.72%, with a considerable variation among facilities. Adherence of prescribers to standard treatment guidelines showed only 70.08% of prescriptions were in accordance with the national guidelines for treating various disease conditions. About 61.75 % of the 14 items monitored was available in Public health facilities. Average mean of 66.55% of the medicines prescribed by the physician were dispensed by the health facility medicine dispensing unit. The study revealed a mean stock – out duration of 80.85 days. The correct medicine labeling criteria for prescriptions were met in 62.29% of the analyzed prescriptions. Adequate patient knowledge about the dispensed medicines was met only for 83.85% of patients. Of the 30 facilities, only 19 (63.3%) reported to have \ud
the tools in hand and this was proved by physical observation. Medicine availability of 71.43 % and average stock- out duration of 54.37 days per year and good quality of storage condition were observed at the zonal medical store in the region. The prescribing patterns of essential medicines in the region were varying across district with the quite low number of medicines per prescription. The use of \ud
antibiotics and injectable medicines were considerable low in most health facilities. The overall availability of medicines in the region is still very low. The stock-out duration of essential medicines is still very high in the region. Affordability of essential medicines in the region was good with an overall ratio that indicated the medicines are affordable in public health facilities. The quality indicators show that storage condition of medicines in the region was satisfactory with very low number of expired medicines on the shelves. Furthermore most health facilities have updated STG and NEML that are \ud
used by health care providers. \u
Collaboratively planning for medicines administration: a survey evaluation
No full textAims This survey evaluated the experiences of mental health nurses who had
undergone assessment of their competence in the administration of medicines using
established assessment frameworks.
Background Medicines management activities have at times been widely criticized.
Joint collaborations between Higher Education Authorities and the National Health
Service in education and training can start to address some of these criticisms.
Method A questionnaire using 22 closed and open response questions was distributed
to 827 practising mental health nurses and 44 graduate mental health nurses.
Results A total of 70 registered and 41 graduate mental health nurses who had
completed the assessment of administration competency frameworks responded to
the survey. Response rates were 24 and 96%, respectively. The assessment frameworks
were received positively. Environmental factors were perceived as the main
barrier to medicines safety; however, this was not reflected in how this aspect of the
competency framework was perceived.
Implications for nursing management The administration of medicines is an area of
mental health and all fields of nursing practice that needs attention. The use of
competency frameworks as outlined in the �Medicine with Respect Project� is one
strategy to achieve the improvement in this essential clinical skill.
Keywords: competence, medication management, medicines administration, mental
health nursing, survey evaluatio
Assessing the Rational use of Essential Medicines in Public Health Facilities Montserrado County, Liberia.
Get PDFThe Republic of Liberia has had a fourteen year civil war which has a devastating effect on the lives of people and healthcare infrastructures. Among the many health challenges, irrational use of essential medicines is of high priority. The determinants of the irrational use of essential medicines in the country are unknown. In order to obtain the magnitude at which medicines are used and advance possible recommendations for remedy, a descriptive crosssectional was conducted in 30 public health facilities in Montserrado County, Liberia administrative center. To assess the rational use of essential medicines in public health facilities in Montserrado County, Liberia. A descriptive cross sectional study was conducted according to the (WHO) guidelines for monitoring and assessing country pharmaceutical situation. The study was conducted from March to June, 2012. About 30 TEMs using the WHO model list of 15 medicines (that is a standard set by WHO /DAP for sampling and study of medicines) and an additional 15 medicines of interest were assessed in the targeted healthcare facilities. A total of 486 essential medicines were dispensed in 121 prescriptions. An average of 4 medicines per prescription was encountered. About 42 (67%) TEMs were prescribed by generic names. The availability of the TEMs in the hospitals ranged from 43.3% to 96.7% with St.Joseph Catholic Hospital (97%) ranking the first. In the healthcare centers, about 43% of TEMs were readily available with a range of (33% to 43%) whiles in clinics these ranged from between (13% to 90%). By therapeutic groups, the comparative availability of TEMs showed 93% for analgesics, 90% for antimalarial medicines, 83% for anti-infective agents, 27% for antihelminthics, 37% for vitamins, 43% for antacids, 37% for antihypertensive and 87% for other medicines. In this study, the majority 25 (70%) of the dispensers interviewed were nurse aides and minority being Pharmacists (3%). The pharmacists were mainly deployed in the referral hospitals. Of the 144 out-patients interviewed, 91 (63.3%) of them knew how to take medicines as per indications and 121 (84%) were satisfied with the healthcare services they received. There were no problems of medicines availability in the County. Significant variabilities of essential medicines availability, prescription and dispensing patterns of essential medicines were observed. Unequal medicines distribution patterns were observed between health facilities. Healthcare providers demonstrated the lack of basic skills and knowledge in pharmaceutical management. Irrational use of medicines: unnecessary prescription of injectables and use of brand names of medicines were evident. 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 use of medicines on the other hand is the overuse, underuse or misuses of medicines which results in wastage of scarce resources and widespread health hazards. Example, the use of too many medicines per patient (polypharmacy),inappropriate use of antimicrobial agents, over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medications; and non-adherence to dosing regimens.1 In the prescription practice (lawful medical order by health provider of medicines for use by a patient), the use of brand (trade) names of medicines was observed. Skills in dispensing medicines and poor (inadequate) communication with patients are the main shortfalls encountered among health care providers. STGs were only available and used for malaria, TB and AIDS/HIV
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