Indian Journal of Pharmacology Home 

EDITORIAL
[Download PDF]
Year : 2021  |  Volume : 53  |  Issue : 6  |  Page : 437--439

Social Pharmacology and its impact on clinics

Seema Bansal, Saniya Mahendiratta, Ajay Prakash, Bikash Medhi 
 Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Prof. Bikash Medhi
Department of Pharmacology, Room No: 4044, 4th Floor, Research Block B, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India




How to cite this article:
Bansal S, Mahendiratta S, Prakash A, Medhi B. Social Pharmacology and its impact on clinics.Indian J Pharmacol 2021;53:437-439


How to cite this URL:
Bansal S, Mahendiratta S, Prakash A, Medhi B. Social Pharmacology and its impact on clinics. Indian J Pharmacol [serial online] 2021 [cited 2022 Jan 28 ];53:437-439
Available from: https://www.ijp-online.com/text.asp?2021/53/6/437/334360


Full Text



 Introduction



Social pharmacology describes the relationship between the medicines, individual, and the society. In brief, social pharmacology is the study of the influence of social and cultural variables on drug effect and use. These variables are nonpharmacological in nature. Variables include a variety of cultural variables such as rituals and ethnicity, labels for describing drug effects, interpretation of drug effects, suggestibility, symptom sensitivity, personality, prior mood, and body state. The study of these nonpharmacological variables provides the generation of actual knowledge about the use of marketed drugs. The main objective of social pharmacology is to represent real-life of marketed drugs.[1]

 History



The term was given by Dr. C. W. M Wilson from University of Dublin.[2] It was initially introduced in 60s to assess the effect of addiction drugs on mood and behavior of individuals using these drugs in social settings. Initially, it was known as drug abuse circumstances. However, the development of social pharmacology was started in 80s, with the concept that the field of social pharmacology will cover study of all those nonpharmacological factors which effects usage of drug after postmarketing. Nowadays, the field has expanded its horizon through incorporating contributions from doctors, pharmacists, drug epidemiologists, nurses, lawyers, and communication specialists.[2],[3]

 Need of Social Pharmacology



New drug development process includes different scientific methods which are entirely different from postmarketing setting of a new drug. We study all aspects of drug development procedure before it comes into the market, but there are different factors that affect drug use even after postmarketing. There is a great difference between conditions of clinical research and new social environment in which drug have been exposed for its use.[4] Thus, social pharmacology is needed of an hour in which we study drug properties, availability of drugs, patterns of doctor's prescription, patient compliance, environmental factors, and interrelation between health care professionals, pharmaceutical companies, and consumers. Moreover, in the modern era, most of the people are much aware about health matters. They are much aware what they deserve and quality of care they need. They are intensely involved in taking therapeutic decisions, whenever, they are taking any drug they usually want complete information about drug from experts or using the internet to gain knowledge about drug. Apart-from this consumer belief towards the drug they have to use highly affects the drug usage. Thus, social pharmacology study has been emerging as an need of an hour.

 Mission of Social Pharmacology



To provide information to government and healthcare authorities about safety, efficacy, treatment information, effectiveness, public vision to use marketed drugs, so that they will be able to make decision/guidelines for the safe use of drugs. Moreover, the main objective of social pharmacology is to generate knowledge of the actual use of marketed drugs.

 Major Players of Social Pharmacology



Pharmaceutical industry, health professionals, and health authorities are three major players that play an important role in social pharmacology. The drug product is the center of all. Patient or consumer has a relationship with all these in diverse proportion. Pharmaceutical industry plays a major role in drug discovery they prepare drugs that are more desirable for patient/consumer. They also explain the utility of prepared drug to the health practitioner. Practitioner have to analyze where they have to prescribe the drug, rational to prescribe the drug, self-medication of drug, etc. Regulatory agencies are involved in drug approval process, regulation of drug approval from preclinical studies to clinical studies, from clinical studies to therapeutic practices. Health professionals also identify social and irrational factors affecting drug utilization. Utilization of drug is affected from person to person, gender, age, social status, cultural variables, environment, place, etc.

 Variables of Social Pharmacology



It includes all those nonpharmacological factors which really influence drug use after marketing. Prior mood and body state of the person influence intake of drug and its effect. A very important example of this is use of placebo drug, whenever placebo drugs are administered with well-defined instructions and specific effect mood and state of the person taking drug definitely effect drug use and create future expectations. Beliefs from earlier experiences through the person or guidance by other family members or friends, or information gathered from internet about the drug use definitely affect the drug effect. Physician attitude and setting of administration seem to be more important affecting drug use. Expectations of the consumer towards drug use plays an important role in drug effect. Earlier studies by Penick and Fisher and Crow et al., reported that when subjects have appropriate and well-defined expectation from any drug, that drugs have more pronounced drug effects as compared to drugs that have no expectations.[5] Smith et al., in 1978 reported that future drug-taking experience is also influenced by the past experience about the structure and content of the drug. A study by Powell 1995 reported that physical and social setting can impact the effects of addicting drugs for tolerance and with-drawl symptoms.[6] Cultural variables also influence the perception and interpretation of drug effect. Ritual plays a major role in determining the drug effects mainly due to impact on the drug constituents its preparation and administration.[7] Schachter and Singer, in 2013, reported that labels and description of drugs also influence the use of drugs.[8] Different nonpharmacological variables that influence drug use after postmarketing is shown in [Figure 1].{Figure 1}

 Methods Used in Social Pharmacology to Evaluate the Use of Medicinal Products



To assess prescription pattern and drug consumption pharmacoepidemiologic studies are used. Observational and experimental studies are used to obtain baseline data of drug. Other than this different tools are used in social pharmacology are longitudinal studies, postmarketing studies, pharmacoeconomic, toxicity evaluation, chronopharmacological studies, drug compounding, epidemiological studies, studies on ethical issue guidelines, studies of prescribing drugs for off-label, counterfeit drug studies, pharmacogenomics studies, medication error study, drug compounding studies, study to evaluate interlink between patient, healthcare worker, healthcare administrator and pharmaceutical industry, systematic and meta-analysis studies to evaluate the information available about the drug on the internet. Studies to evaluate methods of drug compounding, labeling, epidemiologic studies on self-medication, over-the-counter drugs, nutraceutical drugs, etc.[9]

 Future Aspects of Social Pharmacology



Different kinds of questions are raised in social pharmacology to find out interrelationship between social and environmental variables, between individual and pharmacogenetics factors, between individual and economic factors. There is an urgent need to study social pharmacological factors affecting the effect of phytomedicines. At present, in very few countries, an individual course for social pharmacology has been started in which various factors which are often neglected by regulating authorities like overuse or miss-use of prescription drugs, use of drugs in specialized populations such as geriatrics, pediatric, pregnancy has been addressed.[10] Apart from the theoretical knowledge course of social pharmacology covers hands-on skills applied in several social pharmacology settings, covers various bioethical concerns, how social pharmacology affects human behavior and society. Several teaching approaches are used in social pharmacology includes database discussions, movies, presentations, pharmaceutical industry trip where students learn the step-by-step procedure of drugs manufacturing, etc., Thus, in future subject of social pharmacology or course related to this field should be started in throughout the world.

 Conclusion



All the above-mentioned studies recommended that about drugs only scientific and medical studies are not enough, social factors are also necessary. Social pharmacology has massive prospective to draw a conclusion about risk/benefit factors, factors influencing safe medication, to propose actions to authorities regulating drug approvals, to minimize negative impact of drugs, and to promote proper and efficient use of medicinal products.

References

1Maiti R, Alloza JL. Social pharmacology: Expanding horizons. Indian J Pharmacol 2014;46:246-50.
2Alloza JL. Social pharmacology: Conceptual remarks. Drug Inf J 2004;38:321-9.
3Alloza JL. Social pharmacology: A further step in public health. Open Soc Sci J 2014;6:8-15.
4Montastruc JL. Social pharmacology: A new topic in clinical pharmacology. Therapie 2002;57:420-6.
5Penick SB, Fisher S. Drug-set interaction: Psychological and physiological effects of epinephrine under differential expectations. Psychosom Med 1965;27:177-82.
6Powell J. Conditioned responses to drug-related stimuli: Is context crucial? Addiction 1995;90:1089-95.
7Lyttle T, Montagne M. Drugs, music, and ideology: A social pharmacological interpretation of the acid house movement. Subst Use Misuse 1992;27:1159-77.
8Schachter S, Singer J, Author D. Cognitive, social, and physiological determinants of emotional state. Psychology 2013;923:293-315.
9Montagne M. Social pharmacology: Integrating pharmaceutical and social science research on drug effects. Drug Inf J 2004;38:315-20.
10Papadopulos JS, Mentis AA, Liapi C. Social pharmacology as an underappreciated field in medical education: A single medical school's experience. Front Pharmacol 2021;12:714707.