50% of Medicines and antibiotics are mis sold


The pharmaceutical industry has come increasingly under fire over the past couple of years with stories emerging of research cover-ups and safety concerns regarding some popular drugs. Now, according to the World Health Organisation (WHO), it appears that over 50% of medicines prescribed, dispensed or sold worldwide are done so inappropriately.

One area of work for the World Health Organisation is to promote the sensible use of medicines worldwide, as they have long considered the inappropriate use of pharmaceuticals to be a major global problem. Common issues include:

  • The use of too many medicines per patient (poly-pharmacy)
  • Overuse of antibiotics and injections
  • Failure to prescribe in accordance with clinical guidelines
  • Inappropriate self-medication

According to WHO, in the developing countries less than 40% of patients are treated according to clinical guidelines. Moreover, less than 60% of children with acute diarrhoea received the oral rehydration therapy most appropriate to treating their condition yet more than 40% receive unnecessary antibiotics. Even more alarming is that only 50-70% of people with pneumonia are treated with appropriate antibiotics, however almost 60% of those with upper respiratory tract infections receive antibiotics inappropriately.

And this is not a problem isolated to developing nations as WHO found that more than 50% of all countries do not implement basic policies to promote rational use of medicines. Of particular concern is the misuse of antibiotics that occurs in all regions with some countries in Europe using 3 times more antibiotics per head of population then other countries with similar disease profiles!

So what are the consequences of incorrect use of medications? Firstly adverse reactions to medication can lead to increased illness and death, with adverse drug reactions ranking among the top ten causes of death in the US. Secondly they are wasteful and use up a significant proportion of healthcare resources - £466 million annually in the UK! Thirdly it is well known that over-use of antibiotics has lead to the dramatic increase of antimicrobial resistance worldwide. Incidents of infection due to the highly resistant bacteria MRSA is becoming increasingly common and costs Europe €900 million annually. Worryingly, while resistance continues to develop to older antibiotics, the development of new antibiotics is stalling. Hence appropriate use of antibiotics is needed now to provide long- term effective treatment for bacterial infections.

Whilst it is important not to place the blame squarely with the medical profession (as a staggering 50% of patients fail to take their medication correctly and many self medicate), WHO has stated that “the use of both diagnostic and treatment guidelines is sub-optimal and could be greatly improved.” Also under fire is the inappropriate and unethical promotion of medicines by pharmaceutical companies. Frighteningly it is becoming increasingly common for healthcare professionals and trainees to get medicine information directly from pharmaceutical companies rather than from accepted and independent clinical guidelines. This can lead to overuse. However direct-to-consumer advertising of prescription medication may also lead to patients pressurising doctors for unnecessary medicines.

Clearly this work from the World Health Organisation highlights faults within the medical profession particularly regarding the prescription of pharmaceutical drugs. NO profession is infallible but this does emphasise the need for us all to take more responsibility for our own health and to do our own research regarding our health and medications – have any of you ever looked at the leaflet inside your pill box and studied the associated side effects? There are still many individuals under the illusion that their GP has an infinite capacity for information on all drugs and all conditions so will know instantly exactly how to ‘cure’ them. However that is simply not possible as shown by this WHO research, which clearly demonstrates that in some circumstances treatment with medication may actually lead to adverse effects. I truly believe that if we stopped asking the impossible from GPs then they would feel less pressure to provide it and would be able to hold their hands up more when they felt drugs were not necessary or when they really do not have the answer. So make 2012 the year you take charge of your health rather than leaving it in the hands of someone else.

by Moira Browne, Academic Manager, Institute of Health Sciences, Nutrition Courses Ireland

If you would like to read more, please see the following websites:

http://www.who.int/mediacentre/factsheets/fs338/en/index.html

http://www.who.int/medicines/areas/rational_use/en/

http://www.who.int/medicines/areas/policy/world_medicines_situation/WMS_ch14_wRational.pdf