Correct use of medicines

What are medications and how should they be used?

Medications are one of the most widely used therapeutic tools today. Its proper use allows the population to obtain enormous benefits in terms of alleviation or prevention of diseases, improving the state of health of sick people, or modifying physiological states.

To achieve a correct use of the drug, there must be a balance between four basic objectives: maximizing its effect, minimizing the risk, respecting the patient’s choice and minimizing costs.

What is self-medication?

Currently, patients are more and better informed, which influences the decisions they make regarding their health. Therefore, it is convenient to define and distinguish between self-care and self-medication.

• Self- care: refers to those cares that the person provides to himself to achieve a better quality of life and with the purpose of strengthening or restoring his health and preventing diseases. It includes daily practices, such as sleep, food or physical exercise, hygienic measures and habits related to reducing the risk of suffering from a disease or preventing a disease itself. Self-care prioritizes lifestyle changes based on incorporating a series of physical and nutritional habits that are as healthy as possible.
• Self-medication: It is said that a person self-medicates when they take a medication by their own decision, without the intervention of a health professional, in order to alleviate a symptom or cure a disease (addictions and drug dependencies are excluded). This is a common practice in our society: the population groups that most habitually consume drugs on their own are women, young people and people who live alone, with a high educational and socioeconomic level and urban residence, according to different studies. However, self-medication is not exempt from risks, related to side effects, adverse reactions, or the lack or loss of efficacy of a medication (such as the generation of resistance to antibiotics, for example). Therefore, before the appearance of any symptom of disease.

What is the proper use of medications?

According to The World Health Organization (WHO), the appropriate use of medicines implies that the patient receives each medicine for the specific indication, in the correct dose, during the established time and at the lowest possible cost for him and for society. That is to say, to use a medicine correctly to achieve its goal: to cure and repair people’s health. However, we must also make rational use of drugs to avoid negative consequences, such as side effects, unwanted interactions or loss of efficacy (disease resistance), as well as to curb unnecessary personal, social and health costs.

According to data from the WHO itself, around a third of the world population lacks access to essential medicines and 50% of patients take them incorrectly.

What are the most common mistakes in the use of medicines?

Although the prescription of a medicine depends on the doctor, and its dispensing from the pharmacist, the patient has to take responsibility for complying with the treatment and the indications given by the health professionals. To do this, patients have to understand and accept the advice prescribed by the healthcare professional from the point of view of lifestyle, as well as the prescribed pharmacological treatment itself.

In order to achieve better therapeutic adherence, or monitoring of drug intake, it is necessary to negotiate the treatment plan between the healthcare professional and the patient. This adherence will be achieved when there is the maximum coincidence between the guidelines given by the health professional and the performance by the patient after reaching an agreement. For example, hours at which it is best for the person to take the drug, levels of exercise that he must perform, diets, etc.

The relevance of non-compliance with a treatment has been studied especially in the context of very frequent diseases, such as arterial hypertension, cholesterol problems or diabetes. For example, in vascular disease, it is estimated that there is a 39% abandonment of the drugs indicated by the family doctor and 22% of those prescribed by specialists, according to studies carried out in specific population groups.

In this sense, the most common failures when opting for a medication management service and that prevent therapeutic adherence are related to the following:

• Not following the schedule in which each dose must be taken. This is very important, because it is established to guarantee efficiency.
• Miss a dose. This can mean a loss of total effectiveness, for example in the reappearance of pain.
• Not completing the duration of a treatment because we think we feel better. For example, when we take an antibiotic, the improvement appears after a few days but the infection has not been eliminated from our body.
• Forget about medicines when we travel. This happens especially in chronic diseases because we associate a trip with being on vacation and taking a break from medication, which is a serious mistake.
• Stop taking chronic medication so that our body ‘rests’.
• Not following the recommendations for drug intake in relation to meals. For example, pills to lower blood sugar need to be taken half an hour before eating so that when we start eating, our blood sugar levels do not rise.
• Not giving the doctor the correct information about the symptoms or medications we take, or failing to provide data. This is very common among older people who come to take two or three drugs with different names for the same problem. This can lead to serious poisoning or drug interactions.
• Recommend drugs to other people because we have done well for similar symptoms. There are no diseases but patients, that is, the doctor adapts to each patient the therapy he needs according to his characteristics.
• Some factors that favor non-compliance are: the lack of health education about the disease suffered; the complexity of the prescribed treatment; the poor health professional-patient relationship; adverse reactions; and the lack of family, social and health support. Elderly patients are the largest consumers of prescription drugs and constitute a group that is especially susceptible to poorer therapeutic adherence.