Anwar Muhammad Farooq, Daud Nur Aizati Athirah, Hussain Rabia
Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Penang, Malaysia.
J Pharm Policy Pract. 2025 Aug 27;18(1):2544656. doi: 10.1080/20523211.2025.2544656. eCollection 2025.
Over the past few decades, the emergence of irrational medicine use has become a significant global health challenge. It has contributed to medication errors, adverse drug reactions, higher treatment costs, increased morbidity, and mortality. Problems with irrational prescribing are a matter of concern in low and middle-income countries, where regulatory control is underdeveloped, healthcare systems are constrained by economic pressures, and there is a shortage of trained personnel. The World Health Organization (WHO) developed core prescribing indicators to assess and promote rational medication use for healthcare settings. These include indicators measuring polypharmacy, antibiotic use, injectable use, generic prescribing, and adherence to essential medicine lists. This narrative commentary explores the potential of WHO prescribing indicators in promoting the rational use of medicines, highlighting their role in patient safety and supporting evidence-based prescribing practices. The five key areas of these indicators provide valuable insights into prescribing practices in healthcare settings of low and middle-income countries. These indicators also support the WHO's initiative of Medication without Harm. Despite their potential strengths, there are some potential limitations, such as failing to capture the data behind the prescribing practices of prescribers and their utility in specialised healthcare settings. The future of rational prescribing lies in adapting these tools through qualitative assessments, comprehensive data collection methods that include qualitative study design approaches, and targeted training interventions to ensure safe, effective, and equitable medication practices across healthcare systems globally.
在过去几十年里，不合理用药的出现已成为一项重大的全球卫生挑战。它导致了用药错误、药物不良反应、治疗成本增加、发病率和死亡率上升。在低收入和中等收入国家，不合理处方问题令人担忧，这些国家监管控制不完善，医疗保健系统受到经济压力的制约，且缺乏训练有素的人员。世界卫生组织（WHO）制定了核心处方指标，以评估和促进医疗机构合理用药。这些指标包括衡量多重用药、抗生素使用、注射剂使用、通用名处方以及对基本药物清单的依从性等指标。这篇叙述性评论探讨了WHO处方指标在促进合理用药方面的潜力，强调了它们在患者安全方面的作用以及对循证处方实践的支持。这些指标的五个关键领域为低收入和中等收入国家医疗机构的处方实践提供了有价值的见解。这些指标还支持WHO的“无害用药”倡议。尽管它们有潜在优势，但也存在一些潜在局限性，比如未能获取开处方者处方行为背后的数据以及它们在专科医疗环境中的效用。合理处方的未来在于通过定性评估、包括定性研究设计方法在内的全面数据收集方法以及有针对性的培训干预来调整这些工具，以确保全球医疗保健系统中安全、有效和公平的用药实践。
