National Drug Policy Explained Essay (Review)

The Key Components of a National Drug Policy

A national drug policy is a commitment to a goal and guide for action that involves a complex course of development, implementation, as well as monitoring (World Health Organization: How to Develop and Implement a National Drug Process 2003). The policy articulates and prioritizes short-term to long-term objectives set by the nation for the pharmaceutical sector, and establishes effective strategies that allows for actualization of the policies. Furthermore, it provides a clear framework through which all activities of the pharmaceutical sector can be coordinated; thereby, promoting equity and sustainability of the pharmaceutical sector (Medscape: Add This to Your Salad Bar 2012).

How to Support the Quality Use of Medicines

Relevant sources advice that patients should be given medications according to their clinical requirements, in appropriate doses, span of time, as well as within their financial ability (World Health Organization: Promoting Rational Use of Medicines 2002). Any use of medicine in a manner that is not compliant with the assertion is considered as being an irrational use of medicine (Waknine 2005). Some of the methods I would use include but are not limited to the following:

1. Clinical Guidelines: I will participate in the development, adaption, as well as adoption of clinical guidelines and emphasize that all concerned professionals follow these guidelines.
2. Supervision, audit and Feedback: In addition, I will advocate for effective drug use supervision in order to ensure appropriate quality of care. This may be achieved through supervision, audit, and feedback forms that are provided to peers and supervisors (Australian Government Department of Health and Ageing 2004).

Appropriate Drug Information

As a paramedic, it is indispensable to have an individual list of suitable drug information resources that I can consult whenever is required: The following drug information resources are considered of substantial value; hence, I have selected them for future consultations.

1. Antiretroviral Treatment (ARV) of Adult Infection: This is a restructured guideline that contains new drugs and monitoring approaches including the notion of an additional preventive effect of HAART (British Columbia Center for Excellence in HIV/AIDS: Therapeutic Guidelines 2011). Citation (Reference List)
2. Oxford Handbook of Practical Drug Therapy: It is fully revised in line with current NICE guidelines and features real clinical guidelines that illustrate practical prescribing problems (Richards et al. 2011). Citation (Reference List).

Over-the-Counter Medicines

Hawthorn is a thorny shrub with white, red, or pink flowers whose leaves and flowers are utilized in the preparation of liquid extracts. It has several health benefits that may be beneficial for the following conditions:

1. Heart disease
2. Digestive and kidney problems
3. Heart failure and other heat conditions.
4. Mental health problems

Contraindications:

1. Mature people may experience dizziness, headache, and stomach discomfort.
2. May interact with other drugs.

Identified Journal Articles

Journal Excerpt 1: Hawthorn Extract for Treating Chronic Heart Failure: Meta-analysis of Randomized Trials (Pittler, Schmidt & Ernst 2003)

Abstract

“The aim of this meta-analysis was to assess the evidence from rigorous clinical trials of the use of hawthorn extract to treat patients with chronic heart failure. We searched the literature using MEDLINE, EMBASE, the Cochrane Library, CINAHL, CISCOM, and AMED. Experts on and manufacturers of commercial preparations containing hawthorn extract were asked to contribute published and unpublished studies. There were no restrictions about the language of publication. Two reviewers independently performed the screening of studies, selection, validation, data extraction, and the assessment of methodological quality. To be included, studies were required to state that they were randomized, double-blind, and placebo controlled, and used hawthorn extract monopreparations. Thirteen trials met all inclusion criteria. In most of the studies, hawthorn was used as an adjunct to conventional treatment. Eight trials including 632 patients with chronic heart failure (New York Heart Association classes I to III) provided data that were suitable for meta-analysis. For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo (weighted mean difference, 7 Watt; 95% confidence interval [CI]: 3 to 11 Watt; P < 0.01; n = 310 patients). The pressure–heart rate product also showed a beneficial decrease (weighted mean difference, −20; 95% CI: −32 to −8; n = 264 patients) with hawthorn treatment. Symptoms such as dyspnea and fatigue improved significantly with hawthorn treatment as compared with placebo. Reported adverse events were infrequent, mild, and transient; they included nausea, dizziness, and cardiac and gastrointestinal complaints. In conclusion, these results suggest that there is a significant benefit from hawthorn extract as an adjunctive treatment for chronic heart failure.” (Pittler, Schmidt & Ernst 2003).

Journal Excerpt 2: Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) Trial (Zick et al. 2009)

Abstract

“Aims Hawthorn’s efficacy when added to contemporary evidence-based heart failure therapy is unknown. We aimed to determine whether hawthorn increases submaximal exercise capacity when added to standard medical therapy.

Methods and results

We performed a randomized, double-blind, placebo-controlled trial in 120 ambulatory patients aged ≥18 years with New York Heart Association (NYHA) class II-III chronic heart failure. All patients received conventional medical therapy, as tolerated, and were randomized to either hawthorn 450 mg twice daily or placebo for 6 months. The primary outcome was change in 6 min walk distance at 6 months. Secondary outcomes included quality of life (QOL) measures, peak oxygen consumption, and anaerobic threshold during maximal treadmill exercise testing, NYHA classification, left ventricular ejection fraction (LVEF), neurohormones, and measures of oxidative stress and inflammation. There were no significant differences between groups in the change in 6 min walk distance (P = 0.61), or on measures of QOL, functional capacity, neurohormones, oxidative stress, or inflammation. A modest difference in LVEF favoured hawthorn (P = 0.04). There were significantly more adverse events reported in the hawthorn group (P = 0.02), although most were non-cardiac.

Conclusion

Hawthorn provides no symptomatic or functional benefit when given with standard medical therapy to patients with heart failure.” (Zick et al. 2009).

Reference List

Australian Government Department of Health and Ageing: The National Strategy for Quality Use of Medicines 2004, Web.

British Columbia Centre for Excellence in HIV/AIDS: Therapeutic Guidelines: Antiretroviral Treatment (ARV) of Adult HIV Infection 2011, Web.

Medscape: Add This to Your Salad Bar (Sound-Alike, Look-Alike Drugs)2005, Web.

Pittler, H., Schmidt, K & Ernst, E 2003, ‘Hawthorn Extract for treating Chronic Heart Failure: Meta-analysis of Randomized Trials’, The American Journal of Medicine, vol. 114, no. 8, pp. 665-674.

Richards, D, Jamie, C, John, R, & Jeffrey, A 2011, Oxford Handbook of Practical Drug Therapy, Oxford University Press, New York.

Waknine, Y 2005,Name Similarities with Tropical Results in Medication Errors, Web.

World Health Organization: How to Develop and Implement a National Drug Policy 2003, Web.

World Health Organization: Promoting Rational Use of Medicines: Core Components 2002, Web.

Zick, S., Bonnie, M., Brenda, G & Keith, A 2009, ‘Hawthorn Extract Randomized Blinded Chronic Hert Failure (HERB CHF) Trial’, European Journal of Heart Failure, vol. 11, no. 10, pp. 990-999.