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Concepts and project objective(s)

Rational use of drugs, according to the Conference of Experts on the Rational Use of Drugs (Nairobi, 1985), 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. There is a huge need for prudent use of currently available drugs by increasing the awareness of patients in relation to the use of medicines (EMEA, 2007). Despite the fact many attempts, on a worldwide level, have been dedicated to the promotion of rational and effective use of drugs, the inappropriate use of medicines continues to be an urgent and widespread problem with serious consequences in terms of poor patient outcomes, adverse reactions, wasted resources and cost (Bond and Hannaford, 2003; WHO Editorial, 2005, and WHO Report 2006). One recent attempt, to standardise the language of risk, has been to produce sets of verbal descriptors that correspond to specific probability ranges, such as those outlined in the European Commission (EC) Pharmaceutical Committee guidelines in 1998 for describing the incidence of adverse effects. The WHO (World Health Organization) and many member states have underlined the need for more to be done so as to rectify the serious global problem of irrational use of medicines (Bond and Hannaford, 2003; WHO Report, 2006; WHO Editorial 2005; WHO Drug Information, 1997). Implementation should be based on local evidence, cover both the private and public sectors, and include interventions on multiple levels in the health care system of each country.
Our project aims to identify influential factors in prescribing OTC medication as well as in the inappropriate use of medicines in primary care settings in various Southern European countries, and to implement pilot interventions in order to test the effectiveness of the proposed modifications.
One of the main aims of this project is to ensure medicines are used in a therapeutically sound and cost-effective manner by primary care physicians, patients and community pharmacists, for the better use of medicines in the provision of health care.More specifically, the objectives of our project are:

  • To create scientific partnerships and develop a practice-based network through research collaboration in order to exchange experiences and make comparisons on public health care issues, such as prescribing and use of medicines;

  • To explore beliefs and attitudes, subjective norms and behavioural control perception in predicting intention to prescribe medicines;

  • To explore determinants of patients’ health behaviour regarding prescription of medicines and their rational use;

  • To develop and implement policy and practice recommendations that will enhance and improve health care systems;

  • To promote research, especially on the development of national monitoring systems and sustainable nationwide interventions, and on the promotion of rational medicine use at all levels in the health sector. The recommendations of EMEA, on how to administer and use certain medicines for compassionate use, play a significant role in forming the basis of our proposal (EMEA, 2006).

Using evidence-based methodology, in primary health care, and through the inclusion of various population segments in clinical settings, we seek to identify behaviours and practices of patients and prescribers alike. The proposed methodology will allow us to isolate underlying common elements which can be modified more readily and/or improved upon with various methods, and to use them as indicators for testing innovative and cost-effective practices through tailor-made pilot interventions. This will allow for the drafting of recommendations for realistic changes regarding policy implementation. Also, these actions aim to develop new research methods and generate the scientific basis which is necessary in order to underpin informed policy decisions on health care systems, and more effective and efficient evidence-based strategies for health promotion, disease prevention, guideline compliance, diagnosis and therapy. The key concept underlined by scientific committees of the European Medicines Agency to allow rapid access to safe and effective medicines, to provide for adequately informed patients and users of medicines to facilitate innovation and research public health oriented in the EU (EMEA, 2005), will be duly implemented in this project.
Our project is based on using already well-established collaborations between universities, associations and European, as well as international, networks. It, also, aims to create bridges for the utilisation of the combined expertise of various professionals in the primary health care sector. We seek to further develop cross-border cooperation between health care systems and experts, as well as practitioners. We also aim to improve already implemented practices by recommending effective policy changes beyond a national level, by strengthening the dialogue with institutions and professional health care organisations in terms of the implementation plan of the EMEA (EMEA, 2005). Through the dissemination of evidence-based information and knowledge exchange concerning the safe, effective and cost-effective use of medicines, we will be contributing in effecting strategic changes towards achieving better health in Europe, as per the objectives of the new Programme of Community Action in the field of Health (2007-2013).