Learning to Use
Medicines Sensibly
18CHAPTER
18-1
Helping health workers learn to use
medicines wisely is not easy. But this is
not because the knowledge and skills
needed are difficult. It is because the
misuse and overuse of medicines is so
common—among doctors and among
people in general.
Even in wealthy countries, where
there are stricter controls on the
marketing and use of medications,
studies show that a great many
doctors consistently misuse medicines.
Either they prescribe too many, give the
wrong medicines for certain illnesses, or
recommend expensive medicines when
cheaper ones would work as well.
Misprescribing of antibiotics is an
especially common problem (see
Chapter 19). For example, a study in
the United States showed that up
to 70% of doctors’ prescriptions for
Because Ihc overuse of medicine
is such a big problem in many
areas, health workers should place
great emphasis on when not to use
medicines.
tetracycline were for treating the common cold—for which no antibiotic does any
good! (See WTND, p. 163 and 350.) In poorer countries, the misuse—and overuse—
of medicines tends to be even greater.
SOME REASONS FOR THE
WIDESPREAD MISUSE AND
OVERUSE OF MEDICINES:
Health workers should discuss
these facts and help make
everyone aware of them.
1. Big business. The production and marketing of modern medicines is one of the biggest,
most profitable businesses in the world. Drug companies are continually inventing new
products to increase their sales and profits. Some of these medicines are useful. But at least
90% of medicines on the market today are unnecessary. Doctors prescribe them, and
people buy them, because the drug companies spend millions on advertising.
2. False advertising. Especially in poor countries, much of the advertising, and even
the information published in ‘pharmaceutical indexes’, is misleading or false. Information on
dangerous side effects is often not included. Risky medicines are frequently recommended for
illnesses less dangerous than the medicines. (For example, chloramphenicol has often been
advertised as a treatment for minor diarrhea and respiratory infections.)