Acta Pædiatrica ISSN 0803-5253
READER’S FORUM
Review of Italian primary care paediatricians identifies 38 commonly prescribed drugs for children [letter] I was interested to read Piovani et al.s study (1), which showed that just 38 of the drugs prescribed by Italian primary care paediatricians accounted for 83% of the cartons of the 381 drugs prescribed. These results suggest the need to reflect on how the medical community, health policy makers and representatives of the pharmaceutical industry are involved in prescribing. Ideally, drug production should correspond to the needs of the population, but this is a complex socio-economic issue that goes far beyond the remit of doctors. Nowadays, substantial resources are invested in producing drugs that have similar pharmacological effects, even though those resources could be used for other high-priority production lines. In addition, a considerable number of medical prescriptions are inappropriate and clinicians face harder decisions as they choose from large number of drugs to treat conditions (1,2). Clinicians should have access to an essential list of medicines that can be used to solve their patients most frequent health problems. As health systems in each country have particular characteristics that correspond with
socio-economic development level and the most common health issues of their populations, each country should draw up policies to enable clinicians to make more rational use of drugs. Promoting the rational use of medicines has received little political attention and has not been incorporated into the health systems of a number of countries. Many developed countries have adapted their health systems to address this issue, but few low-income and middleincome countries have done this (2). Cuba has had an active national drugs programme, which aims to improve prescribing and public access, since 1991. The Drug Basic Set (DBS) is updated every year and some drugs that were imported before the programme are now produced in Cuba. For instance, in 2014, there were 888 drugs in the DBS and 592 drugs were produced in the country (3). This document lays down prescribing regulations for drugs and natural products, and organisations such as hospitals and institutes are expected to revise their DBS once a year. Although there is no specific DBS for family paediatricians, the Cuban experience may prove valuable for other countries. In developed countries, like those in the European Union, one of the first steps towards the rational use of medicines will be to identify essential medicines for each speciality, such as primary care paediatrics. This action will
ª2015 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd 2015 104, p. e187
contribute to reaching the World Health Organizations goal for Primary Health Care in the 21st century (2). Piovani et al.s (1) study specifically focussed on Italy, but this initiative could be generalised to the rest of the European Union.
References 1. Piovani D, Clavenna A, Bonati M, PeFAB group. Review of Italian primary care paediatricians identifies 38 commonly prescribed drugs for children. Acta Paediatr 2014; 103: e532–7. 2. World Health Organization. WHO Medicines Strategy 2008–2013, Draft 8. Available at: http:// www.who.int/medicines/publications/Medicines_ Strategy_draft08-13.pdf (accessed January 2, 2015). 3. Colectivo de autores. Cuadro basico de medicamentos. La Habana: Editorial Ciencias Medicas, 2014. Available at: http://www.bvs.sld. cu/libros/cuadro_basico_medicamentos/cuadro_ basico_completo.pdf (accessed January 7, 2015). DOI:10.1111/apa.12934
Gerardo R Robaina Castellanos trico Servicio de Neonatologıa, Hospital Gineco-obste Docente Provincial de Matanzas, Matanzas, Cuba Correspondence Gerardo R Robaina Castellanos, Servicio de Neonatrico Docente Provintologıa, Hospital Gineco-obste n y Santa cial de Matanzas, Santa Cristina entre Unio Cecilia, Versalles, Matanzas, Cuba. Tel: 0-53-45-269500| Email: [email protected]
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Copyright of Acta Paediatrica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
READER’S FORUM
Review of Italian primary care paediatricians identifies 38 commonly prescribed drugs for children [letter] I was interested to read Piovani et al.s study (1), which showed that just 38 of the drugs prescribed by Italian primary care paediatricians accounted for 83% of the cartons of the 381 drugs prescribed. These results suggest the need to reflect on how the medical community, health policy makers and representatives of the pharmaceutical industry are involved in prescribing. Ideally, drug production should correspond to the needs of the population, but this is a complex socio-economic issue that goes far beyond the remit of doctors. Nowadays, substantial resources are invested in producing drugs that have similar pharmacological effects, even though those resources could be used for other high-priority production lines. In addition, a considerable number of medical prescriptions are inappropriate and clinicians face harder decisions as they choose from large number of drugs to treat conditions (1,2). Clinicians should have access to an essential list of medicines that can be used to solve their patients most frequent health problems. As health systems in each country have particular characteristics that correspond with
socio-economic development level and the most common health issues of their populations, each country should draw up policies to enable clinicians to make more rational use of drugs. Promoting the rational use of medicines has received little political attention and has not been incorporated into the health systems of a number of countries. Many developed countries have adapted their health systems to address this issue, but few low-income and middleincome countries have done this (2). Cuba has had an active national drugs programme, which aims to improve prescribing and public access, since 1991. The Drug Basic Set (DBS) is updated every year and some drugs that were imported before the programme are now produced in Cuba. For instance, in 2014, there were 888 drugs in the DBS and 592 drugs were produced in the country (3). This document lays down prescribing regulations for drugs and natural products, and organisations such as hospitals and institutes are expected to revise their DBS once a year. Although there is no specific DBS for family paediatricians, the Cuban experience may prove valuable for other countries. In developed countries, like those in the European Union, one of the first steps towards the rational use of medicines will be to identify essential medicines for each speciality, such as primary care paediatrics. This action will
ª2015 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd 2015 104, p. e187
contribute to reaching the World Health Organizations goal for Primary Health Care in the 21st century (2). Piovani et al.s (1) study specifically focussed on Italy, but this initiative could be generalised to the rest of the European Union.
References 1. Piovani D, Clavenna A, Bonati M, PeFAB group. Review of Italian primary care paediatricians identifies 38 commonly prescribed drugs for children. Acta Paediatr 2014; 103: e532–7. 2. World Health Organization. WHO Medicines Strategy 2008–2013, Draft 8. Available at: http:// www.who.int/medicines/publications/Medicines_ Strategy_draft08-13.pdf (accessed January 2, 2015). 3. Colectivo de autores. Cuadro basico de medicamentos. La Habana: Editorial Ciencias Medicas, 2014. Available at: http://www.bvs.sld. cu/libros/cuadro_basico_medicamentos/cuadro_ basico_completo.pdf (accessed January 7, 2015). DOI:10.1111/apa.12934
Gerardo R Robaina Castellanos trico Servicio de Neonatologıa, Hospital Gineco-obste Docente Provincial de Matanzas, Matanzas, Cuba Correspondence Gerardo R Robaina Castellanos, Servicio de Neonatrico Docente Provintologıa, Hospital Gineco-obste n y Santa cial de Matanzas, Santa Cristina entre Unio Cecilia, Versalles, Matanzas, Cuba. Tel: 0-53-45-269500| Email: [email protected]
e187
Copyright of Acta Paediatrica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
