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the patient expires, they realise that they had been wrong all along, that
they had mistaken malaria for kala-azar or vice-versa. These doctors have
even mistaken malaria for tuberculosis. Prodyot himself made such a serious
blunder. He had been burdened with painful thoughts ever since the child
died.
The way they served the
prescribed drugs at Benoy's
left a lot to be desired. If one of the ingredients was not available,
they would put in anything they wished, or just make it without it. None
of the mixtures were made as they should be, the various ingredients did
not dissolve properly. They brought the drugs in one lot and used them
for one year, long after they had lost their potency. The modern drugs
which required to be kept at a special temperature or away from light
were not kept according to specification. Ignorance, neglect and profit-motive
reigned supreme, even where it was a question of life and death. Prodyot
has reason to believe that on top of everything Benoy sold spurious drugs.
And his charges were exorbitant,
poor village people were innocent victims of his greed for money. If they
took anything on credit, the figure in Benoy's
book swelled gradually. When Prodyot looked at their pale faces, he felt
at once pity and outrage. He often felt that these stupid people did not
deserve to live. Let them die. No matter how much you try to convince
them, they would not understand. They would never see beyond herbal drugs,
amulets, magic cures and Jeevan Mashay's
intuition.
Something should be done
about it ! So Prodyot had decided to start a dispensary and a clinic with
the help of his friend and the local doctors. There was no reason why
it should not run ....
- Arogyaniketan,
Tarashankar Bandopadhyay
The need
for consumer action cannot be over-emphasised in view of the aggressive
and unethical marketing practices employed by the pharmaceutical companies.
Consumer awareness is an important pre-requisite for consumer action.
Consumers, individually or as a group, can play a key role in protecting
themselves and preventing unethical promotion of drugs, and unnecessary
suffering caused by dangerous drugs or by irrational use of drugs.
Prescribers
in turn can facilitate patient compliance of drugs by doing several things.
For an illustrative list, see the box overleaf.
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Aids
to Improving Patient Adherence to Treatment
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Patient leaflets
Patient leaflets reinforce the information given by the prescriber
and pharmacist. The text should be in clear, common language and
in easily legible print.
Pictorials
and short descriptions
If
the patient cannot read, try pictorials. If they are not available,
make pictorials or short descriptions for your own P-drugs, and
photocopy them.
Day
calendar
A day
calendar indicates which drug should be taken at different times
of the day. It can use words or pictorials: a low sun on the left
for morning, a high sun for midday, a sinking sun for the end of
the day and a moon for the night.
Drug
passport
A small
book or leaflet with an overview of the different drugs that the
patient is using, including recommended dosages.
Dosage
box
The
dosage box is becoming popular in industrialised countries. It is
especially helpful when many different drugs are used at different
times during the day. The box has compartments for the different
times per day (usually four), spread over seven days. It can then
be refilled each week. If cost is a problem, the box can be made
locally from cardboard. In tropical countries a cool and clean place
to store the box will be necessary.
Even
if the patient aids described here do not exist in your country,
with creativity you can often find your own solutions. The important
thing is to give your patients the information and tools they need
to use drugs appropriately.
Source
: Guide to Good Prescribing. WHO Action Programme on Essential
Drugs, Geneva, 1995.
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