[Adequancy of the pharmacological disponibility in a Department of Internal Medicine to the WHO essential drug list].

INTRODUCTION

Since several years ago, the World Health Organization (WHO), publishes the Essential Drug List (EDL) including medicines that are used to cover the mayor health community problems. Drugs are selected in terms of importance, usefulness, safety and cost-effectiveness. There is no enough data about adequacy between this list and the current medical practise in Internal Medicine.

MATERIAL AND METHODS

Both EDL (13 edition, reviewed on April 2003) and the list of medicines used in the Internal Medicine Department from the Hospital da Barbanza, Riveira, A Coruña (Spain), Fundación Pública del Servizo Galego de Saúde in 2004-2005 were compared.

RESULTS

From the 27 groups included in the EDL, 2 groups were excluded because no regular use in Internal Medicine. Among the other 25 groups there were significant differences in 24 groups. Just in one group both lists were identical. In all the 24 groups with differences, we used an smaller amount of drugs that recommended in the EDL. We analysed 15 groups (the groups with at least 5 differences between both lists). Causes identified were as follows: drugs used in diseases that we used to send to another hospital (Reference Hospital) in groups 6,8 and 12; drugs not commonly prescribed in Internal Medicine in groups 1,4,13,14,18,19 and 21, and finally drugs not currently financed by the National Health System (group 27).

CONCLUSIONS

After examining the adequacy of the list of drugs prescribed in Internal Medicine in a Community Hospital we conclude that its use is significantly lower than the standard recommendations derived from de WHO. Identified causes are treatments not covered in a Community Hospital needing to transfer patients to another hospital and the inclusion of drugs not commonly used in Internal Medicine. The WHO estimates that over 2000 million people can not currently access to essential drugs nor vaccines all over the world. The problem is not just a health problem but also a social, economic and ethic one. So, an accurate use of such essential drugs in developed Health Systems could be a good example of efficiency.