The rational construction of an essential drug list, considering the patient's need, drug safety, availability and the best cost-benefit ratio, is based on drug safety, efficacy and quality. However, in daily practice, the prescriber's decision is mostly influenced by drug effectiveness, following criteria that increase adherence to the treatment, such as relative drug toxicity, convenience, cost and prescriber's experience. In addition, frequent launching of new molecules for the same therapeutic indication, together with wide publicity targeting prescribers, interferes with the decision-making process. Similarly, the bonuses offered by the industry for over-the-counter drug sales interfere with the consumer's choice. The confrontation between known human biological variability and the knowledge that there is no absolute similarity between drugs of the same therapeutic class, or even generic drugs, has an impact on the prescriber's drug list, which should include the concept of first and second choice drugs. Prescribers' unfamiliarity with these subjects is a determinant factor for irrational drug use: a public health issue. The objective was to introduce to drug prescribers information that can help them building up a rational drug list for their patients, based on the National Health Surveillance Agency (Anvisa) experience of drug regulation.

Abstract:To develop a teaching and learning environment, on-line and free, to provide technical information with health professional team from Epidemiological Health Surveillance and Nosocomial Infection Control Groups in Brazil. The first Brazilian experience of e-learning was carried out through a partnership between the National Health Surveillance Agency (ANVISA) and Federal University of São Paulo (UNIFESP). The course supported by different approaches: internet, telephone, books and CD (compact disk). The course had five topics: legislation, epidemiological surveillance, investigation of outbreaks and prevention of infections, occupational risk and isolation, with 20 days each topic and 250 h. Each topic finished with an evaluation and one classroom course. The student's number was 236, with 188 selected, 97.7% enrolled in the course and with 3% of non-approval. The students characteristics were: mean age 41.9 years, female gender majority 84.50 and 54.3% nursing, 15.9% physicians and 10.4% pharmacists. In Brazil, with difficulties to have access to knowledge opportunities, HAI's course would be an alternative to teach about infection control.

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