Introduction to QUM

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"

[WHO definition]

Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. Examples of irrational use of medicines include: use of too many medicines per patient ("poly-pharmacy"); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medication, often of prescription-only medicines; non-adherence to dosing regimes. [Source from WHO]

To improve the quality of medication usage, currently, WHO movement has extended to "Responsible Use of Medicines" and has set policies for better and cost-effective health care.

Quality Use of Medicines involve medicines being used:

• Judiciously, using medicines only after considering all other options
• Appropriately, choosing a medicine after appraisal of factors including risk-benefit analysis, treatment length and cost
• Safely, minimising misuse and abuse
• Efficaciously, having a quantifiable benefit to the patient’s health and/or quality of life

[Source: Department of Health and Ageing – Quality Use of Medicines, Australia, 2008]

In Malaysia, QUM is the responsibility of all stakeholders i.e. consumers, healthcare providers, pharmaceutical industries and media. Strategies to promote better health outcomes include (1) Development and implimentation of model of best practices, (2) Education and training, (3) Provision of timely and accurate information on medicines, (4) Strengthening seamless care between public and private health care providers, (5) Reserach and development in QUM and (6) Engagement of payers involved in reimbursements for medicine use.

[Malaysia National Medicine Policy (DUNas), 2nd Edition, 2012]

In our research focus, Quality Use of Medicines involves patient-centered and health care provider-oriented movements, with the documentation stressing the importance of patient-professional communication along with patient knowledge and understanding their medicines, and health-care providers' knowledge, attitude and practice toward prescribing and handling of medications.