Abstract:
:Globally, it is possible that less than half of all patients are treated in compliance with guidelines and more than half of all patients fail to take their medicines as prescribed or dispensed. Such inappropriate use is wasteful of resources and causes patient harm in terms of lack of satisfactory outcome, serious adverse events and increased antimicrobial resistance. Combating inappropriate use of medicines involves four major steps: measuring the use of medicines; identifying the determinants of inappropriate use; developing, implementing and evaluating the impact of interventions to improve the use of medicines while taking into account the factors underlying inappropriate use; and working towards an enabling policy framework that encourages appropriate use. Global evidence on how to effectively combat inappropriate use of medicines is discussed herein, with reference to the aforementioned four steps. Most interventions undertaken to combat inappropriate use of medicines have been educational in nature, have had a relatively small impact and have not taken into account the determinants of behavior. A combination of interventions, involving managerial as well as educational components, appears to be more effective than a single intervention. Less than half of countries have a policy framework that actively encourages appropriate use of medicines. Since health systems are varied and complex, a nationally coordinated package of interventions and policies, contextualized to each country, will be needed to have any substantial impact on medicine use. There is now increasing global awareness of the need to strengthen health systems, to have national coordination to combat inappropriate use of medicines and to have coordination of international aid to developing countries in order to ensure it contributes to combating inappropriate use of medicines. The opportunities this presents for combating inappropriate use of medicines are discussed in this article.
journal_name
Expert Rev Clin Pharmacoljournal_title
Expert review of clinical pharmacologyauthors
Holloway KAdoi
10.1586/ecp.11.14subject
Has Abstractpub_date
2011-05-01 00:00:00pages
335-48issue
3eissn
1751-2433issn
1751-2441journal_volume
4pub_type
杂志文章,评审abstract::Respiratory distress syndrome (RDS) is the leading cause of neonatal morbidity and mortality in premature infants. It is caused by surfactant deficiency and lung immaturity. Lucinactant is a synthetic surfactant containing sinapultide, a bioengineered peptide mimic of surfactant-associated protein B. A meta-analysis o...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.12.80
更新日期:2013-03-01 00:00:00
abstract::Research on the specific effects of sex and gender on pharmacokinetics and pharmacodynamics, as well as safety profile tolerability and drug efficacy, of medications remain meager because female animals and women have only recently been included in the pharmacological domain. To date, the influence of sex and gender o...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2014.922866
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Pharmacological inhibition of immune checkpoint receptors or their ligands represents a transformative breakthrough in the management of multiple cancers. However, immune checkpoint inhibitors have yet to be FDA-approved for the management of metastatic prostate cancer (PCa), the commonest non-cutaneous ma...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1464388
更新日期:2018-05-01 00:00:00
abstract::Introduction: The placenta is a temporary and unique organ that allows for the physical connection between a mother and fetus; this organ regulates the transport of gases and nutrients mediating the elimination of waste products contained in the fetal circulation. The placenta performs metabolic and excretion function...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2020.1733412
更新日期:2020-03-01 00:00:00
abstract::Pregnancy represents a major challenge in the management of patients with systemic lupus erythematosus, with substantial risks to both mother and baby. Over the past 40 years there have been major improvements in outcomes. This partly relates to the discovery of the antiphospholipid syndrome, which has transformed man...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/ecp.10.55
更新日期:2010-11-01 00:00:00
abstract::Contraceptive management in women with epilepsy is critical owing to the potential maternal and fetal risks if contraception or seizure management fails. This article briefly describes the pharmacokinetic interactions between antiepileptic drugs (AEDs) and hormonal contraceptives and the rational strategies that may o...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/ecp.10.3
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Allogeneic hematopoietic cell transplants (allo-HCT) recipients are at the high-risk of reactivation of cytomegalovirus (CMV), and reactivation is associated with significant morbidity and mortality. Although available anti-CMV therapies may be effective for the prevention of CMV, they are plagued by unacc...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1500897
更新日期:2018-10-01 00:00:00
abstract::Background: The RESORT trial showed no longer relapse free survival (RFS) with sorafenib following radical metastasectomy in metastatic renal cell carcinoma. We present the updated 42-month follow-up data. Methods: The phase II RESORT trial randomized patients to sorafenib or observation within 12 weeks from surgery. ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1080/17512433.2021.1879639
更新日期:2021-01-31 00:00:00
abstract:INTRODUCTION:Induction chemotherapy based on anthracyclines and cytarabine (Ara-C) combination remains the standard of care for acute myeloid leukemia (AML) patients who are considered candidate for intensive and curative approaches. However, the toxicity of this regimen is high, with disappointing clinical outcomes am...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1080/17512433.2019.1573668
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:Gaucher disease (GD) is an autosomal recessive disorder resulting from the deficiency of the lysosomal enzyme glucocerebrosidase (b-glucosidase), associated with varying degrees of visceral, bone and central nervous system pathology, leading to wide phenotypic diversity. Response to therapy and clinical ou...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1549486
更新日期:2018-12-01 00:00:00
abstract::The oxazolidinones are a new class of antibiotics whose mechanism of action is the inhibition of bacterial protein synthesis by binding to the 50S ribosomal subunit. Linezolid is the first member of this class of antibiotics to be approved by the US FDA and other regulatory bodies for the treatment of infections cause...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/17512433.1.4.479
更新日期:2008-07-01 00:00:00
abstract::Neuroblastoma (NB) is the most common extra cranial solid tumor of childhood, with 60% of patients presenting with high risk (HR) NB by means of clinical, pathological and biological features. The 5-year survival rate for HR-NB remains below 40%, with the majority of patients suffering relapse from chemorefractory tum...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2016.1160775
更新日期:2016-01-01 00:00:00
abstract::Schizophrenia is a major mental illness with a lifetime prevalence of about 1%. Antipsychotic drugs, with a primary mechanism of action that involves dopamine receptor blockade, are the mainstay in the treatment of the disorder. However, despite optimum antipsychotic treatment, few patients return to pre-morbid levels...
journal_title:Expert review of clinical pharmacology
pub_type: 社论
doi:10.1586/17512433.2016.1095086
更新日期:2016-01-01 00:00:00
abstract::Alzheimer's disease is the most common cause of dementia and is becoming a global health concern. Despite a well-established understanding of the molecular mechanism involved in its pathogenesis, and millions of dollars of investment in drug discovery and clinical trials, no single molecule has yet been approved for i...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2013.811237
更新日期:2013-07-01 00:00:00
abstract::Preeclampsia is a pregnancy-specific multisystem disorder, complicating 2 - 8% of pregnancies, and represents a leading cause of maternal and perinatal morbidity and mortality. Recent investigations have elucidated the understanding of its underlying pathogenic mechanisms. However, despite these advances, therapeutic ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/17512433.2014.944501
更新日期:2014-09-01 00:00:00
abstract::Data from clinical trials, retrospective and cross-sectional studies have quantified the metabolic changes associated with long-term use of antiepileptic drugs (AEDs). AEDs can be associated with weight gain or weight loss, although most are weight neutral. Weight gain is not only a cosmetic problem but also a risk fo...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2015.991716
更新日期:2015-01-01 00:00:00
abstract::The problem of adverse drug reactions is a well-documented global public health problem. Recent withdrawals of several widely used prescription medications in the USA and other countries have raised concerns among patients, clinicians, scientists and policy makers. The increasing interest and concern regarding withdra...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/17512433.1.2.251
更新日期:2008-03-01 00:00:00
abstract::Introduction: Primary endpoints and inclusion/exclusion criteria of biologics and small oral molecules for psoriasis treatment have been evolving due to a better understanding of the pathogenesis and potential risks.Areas covered: We analyzed the designs of key phase 3 pivotal trials of all biologics and small oral mo...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2020.1743175
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:Drug-resistant forms of tuberculosis are a major public health problem with a serious global impact. Although there have recently been two new drugs introduced for the treatment of drug-resistant TB (bedaquiline and delamanid), the current therapeutic armamentarium is limited. Because treatment of drug-res...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1080/17512433.2016.1208562
更新日期:2016-10-01 00:00:00
abstract::Methotrexate is an antifolate agent used in the treatment of various cancers and some autoimmune diseases. In oncology, methotrexate is frequently administered at a high dose (>1 g/m(2)) and comes with various procedures to reduce the occurrence of toxicity and particularly to ensure optimal renal elimination. Drug-dr...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.11.57
更新日期:2011-11-01 00:00:00
abstract:INTRODUCTION:Joint hypermobility (JH) is the hallmark of many hereditary soft connective tissue disorders, including Ehlers-Danlos syndromes and related disorders, disorders of the TGFβ-pathway, lateral meningocele syndrome, arterial tortuosity syndrome, and cutis laxa syndromes. Contemporary practice separates individ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1497973
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:It was assumed for decades that the human placenta serves as a barrier, protecting the fetus from exposure to xenobiotics circulating in the mother. The thalidomide disaster completely reversed this concept. The study of the human placenta is therefore critical to understanding the mechanisms by which xeno...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1425615
更新日期:2018-04-01 00:00:00
abstract::Inflammation plays a critical role in host defense, maintaining cellular and tissue integrity following chemical, physical and biological insults. Inflammation presents in a variety of acute and chronic disease states and can contribute to disease resolution or progression depending upon the type, magnitude and durati...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.11.66
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of polypharmacy (≥5 drugs) among adults and to analyze related factors. METHODS:Cross-sectional study with 1,159 interviewees distributed across 104 cities and 253 primary healthcare services delivered through the Brazilian Unified Health System. Polypharmacy-related factors were ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1080/17512433.2020.1836958
更新日期:2020-12-01 00:00:00
abstract::The last decades were characterized by enormous technological advances resulting in a better understanding of disease pathologies and improvement of treatment strategies. The development of targeted drugs, whose beginning can be traced back to Paul Ehrlich's theory of the 'magic bullet' approximately 100 years ago, is...
journal_title:Expert review of clinical pharmacology
pub_type: 历史文章,杂志文章
doi:10.1586/ecp.12.71
更新日期:2013-01-01 00:00:00
abstract::Sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are recently approved class of anti-hyperglycaemic agents for the treatment of type 2 diabetes mellitus (T2DM). SGLT-2I inhibits renal glucose reabsorption, thereby ensuing urinary glucose excretion in a dose-dependent manner. This caloric loss and osmotic diuresis,...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2016.1131121
更新日期:2016-01-01 00:00:00
abstract::C-X-C chemokine receptor (CXCR)3 and its interferon(IFN)γ-dependent chemokines (CXCL10, CXCL9, CXCL11) are implicated in the immune-pathogenesis of autoimmune thyroiditis (AT), Graves disease (GD) and Graves Ophthalmopathy (GO). In tissue, recruited Th1 lymphocytes produce IFNγ, enhancing the tissue secretion of IFNγ-...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2016.1157468
更新日期:2016-06-01 00:00:00
abstract::Introduction: In September of 2018, the United States Federal Drug Administration (FDA) approved cemiplimab-rwlc (Libtayo) for advanced cutaneous squamous cell carcinoma (CSCC). Cemiplimab is an intravenous human monoclonal antibody directed against programmed cell death-1 receptor (PD-1). Cemiplimab blocks T-cell ina...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2019.1665026
更新日期:2019-10-01 00:00:00
abstract::Second-generation antipsychotics (SGA) have been associated with risk of stroke in elderly patients, but the molecular and genetic background under this association has been poorly investigated. The aim of the present study was to prioritize a list of genes with an SGA altered expression in order to characterize the g...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2014.865515
更新日期:2014-01-01 00:00:00
abstract::After the introduction of anti-tumor necrosis factor (anti-TNF) agents, the clinical outcome of patients with Inflammatory Bowel Disease (IBD) has improved significantly. However, use of anti-TNF therapy is complicated by loss of response. In order to maintain remission, adequate serum levels are required. Hence, ther...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2016.1133288
更新日期:2016-01-01 00:00:00