6
Challenges to effective
drug therapy
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Discuss the impact of the media, the Internet and direct-to-consumer advertising on drug sales and
prescriptions.
2.
Discuss the importance of quality use of medicines and the role of nurses and midwives.
3.
Explain the growing use of over-the-counter drugs and the impact they have on safe medical care.
4.
Discuss the lack of controls on herbal or alternative therapies and the impact this has on safe drug therapy.
5.
Define the off-label use of a drug.
Glossary of key terms
alternative therapy:
includes herbs and other “natural” products as often found in ancient records; these products are not controlled
or tested by the TGA and MEDSAFE (NZ); however, they are often the basis for discovery of an active ingredient that is later
developed into a regulated medication
cost comparison:
a comparison of the relative cost of the same drug provided by different manufacturers to determine the cost to
the consumer
Internet:
the worldwide digital information system accessed through computer systems
off-label use:
use of a drug that is not part of the stated therapeutic indications for which the drug was approved by the TGA and
MEDSAFE (NZ); off-label use may lead to new indications for a drug
self-care:
tendency for people to self-diagnose and determine their own treatment needs
street drugs:
non-prescription drugs with no known therapeutic use; used to enhance mood or increase pleasure
Test your current knowledge of challenges to effective drug therapy with a PrepU Practice Quiz!
T
he dawn of the 21st century arrived with myriad new
considerations and pressures in the healthcare industry.
For the first time, consumers have access to medical
and pharmacological information from many sources.
Consumers are taking steps to demand specific treat-
ments and considerations. Alternative therapies are
being offered and advertised at a record pace, and this
is causing people to rethink their approach to medical
care and the medical system. At the same time, finan-
cial pressures have led to early discharge of people from
healthcare facilities and to provision of outpatient care
for people who, in the past, would have been hospitalised
and monitored closely. Healthcare providers are being
pushed to make decisions about care and prescriptions
based on finances in addition to medical judgement.
Illicit drug use is at an all-time high, bringing increased
health risks and safety concerns. There are increasing
concerns about the environment and the need to protect
it from contamination. Nurses and midwives are often
caught in the middle of all of this change. People, as con-
sumers of healthcare, are demanding information but
may not understand it when they get it. Health teaching
and home care provisions are vital to the success of any
health regimen. The nurse or midwife is frequently in
