Prescribers and users of medicines

A world where every prescriber and user of medicines will have access to independent, reliable, understandable information on the full range of commonly prescribed medicines – and will know where to find it

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Overview

‘Globally, most prescribers receive most of their prescribing information from the pharmaceutical industry and in many countries this is the only information they receive.’ World Medicines Report, WHO

The availability of relevant, reliable information on medicines is a prerequisite for the delivery of effective care. Misuse of medicines, and especially antibiotics, is increasingly recognised as a threat to global health.  

It is unacceptable that prescribers and users of medicines continue to be denied easy access to reliable, essential information on medicines. Prescribers and users of medicines in low- and middle-income countries need free, independent, reliable, understandable information about medicines, in the language of their choice.

The HIFA Project on Information for Prescribers and Users of Medicines is leading the HIFA community towards the realisation of Information on Medicines For All:  

"Every prescriber and user worldwide will have access to independent, reliable, understandable information on the full range of commonly prescribed medicines ­- and will know where to find it." 

In 2018-20, the project was sponsored by Nagasaki University and the Japanese Society for the Promotion of Science to contribute to a systematic review: Information obtained during consultations by primary healthcare workers to aid safe prescribing in low- and lower-middle-income countries

Contact us for further information and ways you can help

Sponsorship opportunity: Please contact us for details.

 

Activities

The HIFA Working Group on Information for Prescribers and Users of Medicines (PUM) is a group of HIFA volunteers who:

  • promote discussion on the HIFA forums on the information needs of PUM, and how these needs can be more effectively addressed.
  • harness insights and perspectives from HIFA members and integrate these into the HIFA Voices database, together with relevant literature
  • lead the HIFA community in advocacy efforts to improve the availability and use of information for PUM.  

Timeline

2013: Launch of Project: “Every prescriber and user of medicines will have access to reliable information on medicines to protect their own health and the health of others”

2014: Publication: Criteria for ‘reliable and useful information on medicines’

2014: Agreement on HIFA SMART goal: “By 2016, every English-speaking prescriber and user worldwide with internet access will have free access to independent, reliable, understandable information on the full range of commonly prescribed medicines – and will know where to find it. By 2018, such information will be available in at least 6 other major languages.”

2016-7: Literature review of medicines information needs and how to meet them: 1. References ; 2. Summary

2017: Information needs assessment of medical students/prescribers in Kenya (submitted for publication)

2017: Medicines Information for All - Improving the availability of information for prescribers and users worldwide: Conference poster

2017-18: Concept note: Roundtable to consider the lack of availability and use of information for prescribers and users in low- and middle-income countries

2018: Systematic review protocol (collaboration with LSHTM): "How do primary healthcare workers in low- and middle-income countries obtain information during consultations to aid safe prescribing: systematic review protocol" (submitted for publication, BMJ Open)

Publications
2020

We are delighted to announce the publication in BMJ Global Health of our first systematic review: How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries.

CITATION: How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries: a systematic review. Chris Smith, Michelle Helena van Velthoven, Nguyen Duc Truong, Nguyen Hai Nam, V Phan Anh, Tareq Mohammed Ali AL-Ahda, Osama Gamal Hassan, Basel Kouz, Nguyen Tien Huy, Malcolm Brewster, Neil Pakenham-Walsh. BMJ Global Health 2020;5:e002094. Published on 2nd April 2020

This paper serves as a vital baseline assessment/situation analysis on which we can build future advocacy and action. There can be no area of health more important than access to reliable information to inform prescribing, no area of health that ios more perverted by commercial interests, and no area of health that presents such an important and growing existential threat to human existence - the predicted post-antibiotic apocalypse, with 50 million deaths per year, partly driven by lack of access to reliable informatioin on antibitics. 

The HIFA Prescribers and Users of Medicines project is seeking sponsorship to continue our work. Please contact the HIFA Coordinator, Neil Pakenham-Walsh: neil@hifa.org

2017

Medicines Information for All
Improving the availability of information for prescribers and users of medicines worldwide
S. Cavanagh, East Anglia Medicines Information Service, C. Rodrigues University of Amsterdam, M. Brewster, Rye Medical Centre and N. Pakenham-Walsh, Healthcare Information for All

“Globally, many prescribers receive most of their prescribing information from the pharmaceutical industry and in many countries this is the only information they receive.” WHO Medicines Report 2011

The HIFA Project on Information for Prescribers and Users of Medicines is leading the HIFA community towards our shared goal: “a world where every prescriber and user of medicines will have access to independent, reliable, understandable information on the full range of commonly prescribed medicines - and will know where to find it.” 

 

 

2017

The HIFA Working Group on Information for Prescribers and Users of Medicines has undertaken a limited review of the literature based on the following headings:

  1. The information sources used for prescribing in Low and Middle Income Countries (LMICs); 
  2. Information sources for consumers in LMICs;
  3. How medicines information is accessed in LMICs; 
  4. The consequences of prescribing with either no information or biased/inaccurate information; 
  5. The benefits / usefulness of different sources of information on medicines; 
  6. Practical aspects of compiling a drug formulary.
 
2017

The HIFA working group on Information for Prescribers and Users of Medicines is undertaking a scoping review of literature on six themes relating to our shared vision (a world where every prescriber and user of medicines will have access to independent, reliable, understandable information on the full range of commonly prescribed medicines ­ and will know where to find  it).

The six themes are:

(1) The information sources used for prescribing in Low and Middle Income Countries (LMICs);
(2) Information sources for consumers in LMICs;
(3) How medicines information is accessed in LMICs
(4) The consequences of prescribing with either no information or biased/inaccurate information;
(5) The benefits / usefulness of different sources of information on medicines;
(6) Practical aspects of compiling a drug formulary.

Over the past year we have searched Medline, Embase, International Pharmaceutical Abstracts, and Google Scholar. We indentified over 1300 papers published in the last 5 years, but only 56 of these papers were relevant to the above themes. So, our first finding is that the evidence base for this area is very limited, given the huge importance of the subject. Please let us know if you are aware of any relevant research - especially from the last 5 years - that is not included on this list. Contact: admin@hifa.org

2014

The following criteria were identified in consultation with the HIFA community:

1. Patient and prescriber information should be consistent.
2. Information should be from transparent governmental sources that can be independently verified.
3. Information should not be commercial in content or tone.
4. Information should be free.
5. Information should be updated in real time.
6. Information is available in a language other than English
7. Information should be Web based and available also on a mobile platform.
8. Information should be easy to find and easy to understand.
9. Information should be appropriate to the intended readership (drug information centre, pharmacist, prescriber, caregiver, citizen…).

“Reliability and usefulness” of any drug information is not all-or-nothing, but is measurable on a spectrum, as a composite “score” on all nine of the above criteria. There is no perfect source; information about medicines is always changing; people around the world should be aware of the risks of medicines, as well as the benefits. Information about the risks should be the same for patients and prescribers, worded (or depicted) in a way that is appropriate and easily understandable to the reader.

Members
Name Country
Arthy Hartwell United Kingdom
Carla Rodrigues Netherlands
Chris Smith United Kingdom
Folasade Olufunke Lawal Nigeria
John Liebhardt United Arab Emirates
John Eyers United Kingdom
Larry Sasich Saudi Arabia
Lorenzo Moja Switzerland
Malcolm Brewster United Kingdom
Neil Pakenham-Walsh United Kingdom
Nicola Magrini Switzerland
Peter Kussin United States
Sandeep Saluja India
Venus Mushininga Zimbabwe
Tom Burnham United Kingdom
Victoria Rutter United Kingdom
Joseph Ana Nigeria
Meghna Joshi-von Heyden United Kingdom
Pauline Roberts Swaziland
Further information

“Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. Examples of irrational use of medicines include: use of too many medicines per patient (“poly-pharmacy”); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medication, often of prescription-only medicines; non-adherence to dosing regimes.”
WHO

“Appropriate use of antibiotics [and other medicines] is only possible if healthcare workers and the public have access to reliable, unbiased information on medicines. Universal access to reliable information on medicines is readily achievable and should be a cornerstone of efforts to promote rational prescribing. There is an urgent need for concerted action.” WHO