Description
- Abstract:
- Background: Pharmaceutical medication consumption has grown by almost 40% internationally over the past decade. Unfortunately, over half of all medications are prescribed, dispensed, administered, or sold incorrectly. Here, we seek to analyze global medication usage through the lens of Rational Use. Rational medication use requires patients to “receive medications appropriate to their clinical needs, in doses that meet their requirements, for an adequate period, and at the lowest cost to them.” Methods: We utilized three distinct methods to evaluate global medication usage. First, we evaluated antiretroviral medication adherence through a randomized controlled trial in Western Kenya. Second, we use local event rates from two regional studies in Eldoret, Kenya, to complete a cost-effectiveness analysis of two anticoagulants for treating venous thromboembolism (VTE). Lastly, we undertook a comprehensive international policy evaluation to assess inappropriate antibiotic usage among 70 countries. Results: In Western Kenya, patients involved in integrated community-based care with group microfinance had higher ART adherence measured by the medication possession ratio than those with only facility-based care. In Eldoret, Kenya, VTE treatment with the anticoagulant rivaroxaban was more effective and cost-saving than standard-of-care treatment with the anticoagulant warfarin. Countries with high-scoring antimicrobial resistance national action plans use antibiotics more judiciously than countries with low-scoring or no national action plans. Conclusions: Through our comprehensive international evaluation, we have identified key interventions that have the potential to significantly increase the rational use of medications globally. This underscores the importance of assessing global medication usage through both high-level policy assessments and more granular analyses at the country level and offers a promising path forward in improving global healthcare.
- Notes:
- Thesis (Ph. D.)--Brown University, 2024
Citation
O'neill, Emily Taylor,
"Evaluating Appropriate Medication Usage: Perspectives from Sub-Saharan Africa to the European Union"
(2024).
Health Services, Policy & Practice Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:ur7qw7mk/
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Health Services, Policy & Practice Theses and Dissertations
Theses and Dissertations for the Health Services, Policy & Practice department....