Experts tell why patients should be taught to self-medicate
In the first nine months of 2023, each Russian left more than 7 thousand rubles in the pharmacy (data from AlfaRm). In terms of the whole country, this is about 980 billion rubles, and a large share of this sea of medicines is bought by people on their own. Experts say that we need to more actively promote the principle of responsible self-medication.
The attitude to over-the-counter drugs is generally very light: half of patients (55%) choose what to be treated with without a doctor's recommendation - people take information on the Internet, from friends and relatives. Although even the most "harmless" drugs have contraindications and can cause harm if used incorrectly. The situation with prescription drugs is no better, as a recent survey of doctors and pharmacy workers conducted by the Association of Health Products Industry (AHPI) and the National Pharmaceutical Chamber showed. More than one-third of pharmacists (35%) reported that pharmacy customers often ask for a prescription drug to be sold to them without a prescription, and another 7% said that almost every customer makes such demands.
Yes, it's not always easy to have the right prescription on hand - an appointment with a doctor, especially a narrow specialist, can take days or weeks. In addition, during the appointment, the doctor is limited in time, it is easier for him to write the appointment simply on a sheet, without filling out a prescription form.
"The survey showed that, fortunately, more and more doctors see the pharmacy as a partner and assistant. Indeed, more than 80% of pharmacists say that visitors ask them for advice, help with drug selection," said Elena Nevolina, executive director of AITZ. - But still many doctors underestimate the level of training of pharmacists and do not see the need for pharmaceutical counseling. Although in our country it is often the pharmacy that becomes the first point of contact between the patient and the health care system, so it would be logical to allow pharmacists to take on additional powers in matters of helping the population".
In fact, pharmacists (and these are specialists with higher medical education) partly substitute for the doctor: as the survey showed, many ask the buyer about his illness - and this makes it possible, if there are alarming symptoms, in time to refer a person to a doctor.
"Self-medication can be justified, but only if we are talking about responsible self-medication. This position is supported by the WHO," said Yuri Zhulev, co-chairman of the All-Russian Patients' Union. - Here is a vivid example: during the pandemic, the Ministry of Health issued a memo, clearly describing how a patient should behave during a mild course of COVID-19. When and how to treat independently at home, and at what symptoms to seek medical help. This was the right move - to free up the energy and resources of overburdened medical centers. Responsible self-treatment is also important in chronic diseases, such as diabetes. The patient must be ready to control his condition and take his medication correctly."
As for pharmaceutical counseling, according to Yuri Zhulev, this is an ambiguous issue. "Pharmacies remain commercial institutions, there is a risk of excessive recommendations", - believes the expert. However, pharmacists themselves in the survey say that they act primarily in the interests of the patient and are ready to take more responsibility.