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Table 3 Comparison of the proportion (%) of countries that attained a particular policy or indicator for rational use of medicines in low, mid and high income countries in 2007 [45]

From: The current status and trend of clinical pharmacology in developing countries

  WHO-countries income category
Parameter/Indicator Low income Mid-income High income
1. Standard Treatment Guidelines (STG) 89% 75% 80%
2. Essential Medicines list (EML): 100% 86% 68%
 • EML-Updated in <5 years 81% 74% 41%
3. Drug Therapeutics Committees (DTC): 38% 58% 74%
4. Prescribing policy or supervision/monitor prescribing
 i) Prescribers at primary care level in public sector
  • Doctors 98% 99% 100%
  • Nurses 89% 60% 66%
  • Pharmacists 37% 16% 3%
  • Other 23% 9% 0%
 ii) Policy on generic medicines in public sector
  • Obligatory use of generics 63% 62% 18%
  • Generic substitution allowed 85% 87% 77%
  • Incentives for prescribing generics 48% 26% 67%
 iii) Prescriptions audit 39% 46% 71%
 iv) Strategy for AMR containment 24% 46% 73%
5. Education and Training in CP: undergraduate and post graduate education (Includes training on EML, STG, pharmacotherapy & Rational prescribing)
  • Doctors 62 ± 3.7% 73 ± 7.1% 88 ± 17.4%
  • Nurses 58 ± 10.8 57 ± 3.0% 73 ± 6.0%
  • Pharmacists 62 ± 11.5% 60 ± 6.7% 80 ± 13.3%
  • Other 33 ± 5.3% 32 ± 6.2% 36 ± 5.3%
6. Continuing Medical Education (CME): Obligatory CME for:
  • Doctors 51% 54% 70%
  • Nurses + paramedics 53% 44% 65%
  • Pharmacists 56% 51% 57%
7. Provision of information on Medicines:
  • Med. Information Centres 36% 52% 75%
  • Medicines formulary 57% 69% 70%
8. Public/Consumer education and information on medicines
  • Education campaigns (A/biotic use) 44% 52% 62%
  • Other rational medicine use topics 60% 56% 73%
9. Medicine promotion & advertising:
  • Regulate Drug prom/advertisement 85% 86% 100%
  1. Key: AMR, antimicrobial resistance; CME, continuing medical education; CP, clinical pharmacology; DTC, drug therapeutics committees; EML, essential medicines; HIC, high income countries; LIC, low income countries; MIC, middle income countries; STG, standard treatment guidelines.