Medicines have an integral part in the health care system all over the world. When the appropriate use of medicine is done, they can cure the different ailments and promote the health of the patients and results in the wellbeing of the patients. However, the irrational use of world is the major issue in this regard and it is practiced all over the world [1]. According to a report issued by the World Health Organization it is reported that half of the medicines are not properly prescribed, dispensed or sold [2]. Moreover patients don’t know how to take the medicine properly. Advancing the balanced utilization of solutions requires powerful strategies and also cooperation between wellbeing experts, patients, and whole groups in the society [3,4].

A precise definition is given by the experts in this regard by the WHO and it summarizes it as,

“Patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community."

It also includes the utilization of medication as per patient safety, its effectiveness, cost and compliance [5].

Irrational prescribing

It refers to endorsing that fails to comply with great benchmarks of treatment. It doesn’t comply with the prescribing standards [5]. It is of following five types:

• Under-prescribing

• Over-prescribing

• Incorrect prescribing

• Extravagant prescribing

• Multiple prescribing

Impact of the irrational use of medicines

The effect of irrational medication is vast and it results in the different conditions. The most important and widely reported impact is in the form of side effects that may be harmful in a way they may sometimes result in mortality. Lederberg reported that the incorrect and inappropriate use of antibiotics is one of the prime factors in this regard [6]. Figure 1 will illustrate the impact of irrational usage of medications.

Figure 1: Some possible impacts of the irrational use of medicines.

Strategies to promote rational drug use

Following are some of the major and supreme roles and strategies in order to eliminate the irrational use of the drugs. The contribution of following is important in this regard:

• WHO

• Pharmacist

• Government

WHO provides the following 12 interventions in facilitating the appropriate usage of medication:

Formation of mandated multi-disciplinary national body to coordinate medicine use policies

Numerous societal and wellbeing framework factors, and also experts and numerous others, add to how medicines are utilized. Hence, a multi-disciplinary approach is expected to create, execute and assess intercessions to advance more sane utilize of medicine. A National Regulatory Authority (RA) that creates and executes the vast majority of the enactment and direction on pharmaceuticals. Ensuring objective utilize will require numerous extra exercises which will require coordination with numerous partners. Hence a national body is expected to arrange approach and methodologies at national level, in both people in general and private areas.

Clinical guidelines

Clinical rules (standard treatment rules, endorsing arrangements) comprise of deliberately created articulations to enable prescribers to settle on choices about proper medicines for particular clinical conditions. Proof based clinical rules are basic to advancing balanced utilization of pharmaceuticals.

Essential medicines list based on treatments of choice

Essential medicines are those that fulfill the need social insurance needs of the population. Using a Essential medicine list (EML) makes medication administration less demanding in all regards; obtainment, stockpiling and dispersion are simpler with less things, what's more, recommending and administering are less demanding for experts in the event that they need to think about less things. A national EML ought to be founded on national clinical rules.

Drugs and therapeutics committees in districts and hospitals

A drugs and therapeutics committee (DTC) also called a pharmacy and therapeutics committee is a board of trustees assigned to guarantee the protected and compelling utilization of prescriptions in the office or region under its locale. Such committees are well-established in industrial countries as a successful way of promoting more rational, cost-effective use of medicines in hospitals.

Problem-based training in pharmacotherapy in undergraduate curricula

Rational pharmacotherapy training, linked to clinical guidelines and essential medicines lists, can help to establish good prescribing habits.

Continuing in-service medical education licensure requirement

CME is a necessity for licensure of wellbeing experts in many industrialized nations. In many developing nations open doors for CME are restricted and there is likewise no motivation since it isn't required for proceeded with licensure.

Supervision, audit and feedback

Supervision is fundamental to guarantee great nature of care. Supervision that is strong, instructive and confront, will be more powerful acknowledged by prescribers over straightforward examination and discipline. Including peers in review and input is especially successful.

Independent medicine information

Provision of independent (unbiased) information is therefore essential.

Public education about medicines

Without adequate information about the dangers and advantages of utilizing medication and when and how to utilize them patients will regularly not get the normal clinical results. Also, may endure antagonistic impacts. This is valid for endorsed medicines, and in addition drugs utilized without the exhortation of wellbeing experts. Governments have a duty to guarantee both the nature of pharmaceuticals and the nature of the data about medications accessible to purchasers.

Avoidance of perverse financial incentives

Financial incentives may strongly promote rational or irrational use.

Appropriate and enforced regulation

Regulation of the activities of all actors involved in the use of medicines is important to ensuring rational use. If authorities are to have any effect, they must be implemented, and the regulatory authority must be sufficiently funded and backed up by the law.

Sufficient government expenditure to ensure availability of medicines and staff

Governments are in charge of contributing the important assets to guarantee that all general health availabilities have adequate, suitably prepared health experts and enough basic prescriptions at moderate costs for all the populace, with particular arrangements for poor people and hindered [7].

The pharmacist take part in enhancing sound medication treatment when he is a section for the patient care group is to ensure the patient the correct utilization of the best medications accessible.

Following are the roles of the pharmacist in promoting rational drug use:

Patient medication counseling

A Pharmacist can set up a different counseling space for guiding the patients. He can keep up points of interest of patient history, hypersensitivities and other vital information for the treatment. In addition, he encourages the patients to take the measurements in appropriate time in order to keep any antagonistic results.

Rational use of medicines

A pharmacist is one of the inevitable members of healthcare team who can help in achieving the goal of rational use of drugs. Promoting the rational use of medicines will result in improved quality and increased accessibility of drugs leading to better quality of life for the community.

Specialist in preventing drug/medicine abuse

A national program known as "Drug specialist against Drug Abuse" was propelled in 1982 in USA. In any case, in India, drug store instruction frameworks still can't seem to perceive the capability of drug specialists in general wellbeing. Drug store understudies ought to be made more patient arranged and all around familiar to go about as a good example in forestalling pharmaceutical manhandle.

Role in self-care and self-medication

Pharmacist can assume an imperative part in self-care and self-medicine of the patient by giving them the vital data about the medications, particularly over the counter (OTC) drugs. The need of great importance is that, drug specialist acknowledge these difficulties strikingly and fearlessly to guarantee safe utilization of solutions notwithstanding amid self-care and self-pharmaceutical.

Combating counterfeit drugs

A pharmacist is required to be ready and side by side in separating the nature of valid pharmaceutical items from the spurious ones, and ought to confine and withhold supply of the medication, once suspected to be fake [8].

• Make sure that they are effective and have smooth implementation in the country.

• Guaranteeing significant, great quality data to the general population on wellbeing matters, including drug matters.

• Setting up or fortifying medication administrative specialists to guarantee.

• Satisfactory enlistment of medications of worthy quality and security.

• Protecting universal nonproprietary names of medications.

• Taking steps to improve prescription practices.

• Improving distribution systems.

• Studying the technical and economic feasibility and extent of local production where that does not exist or exists only to a limited [9].

These are the main responsibilities of the government in order to promote rational drug use.

• Formation of drug policies at national level.

• Implementation of the drug programmers and make sure that these are practiced by the health professionals.

The irrational use of drugs is the worldwide issue. The rational medication is promoted when all the health care professionals along with the regulatory authorities play their effective role and must promote the safe use of medications.