Definition and principles of Quality Use of Medicines (QUM) MCQs With Answer

Introduction

The following quiz on the Definition and Principles of Quality Use of Medicines (QUM) is designed specifically for M.Pharm students to deepen understanding of rational, safe and effective medicine use. It covers core definitions, guiding principles, operational strategies (such as stewardship, formulary management and medication review), stakeholder roles, and measurement approaches used to promote optimal therapeutic outcomes. Questions probe conceptual clarity and clinical application—linking evidence-based prescribing, patient-centred care, pharmacovigilance, deprescribing and cost-effectiveness. Use this set to test knowledge, identify gaps, and prepare for higher-order discussions in clinical pharmacy, policy design and medicines management.

Q1. What is the best succinct definition of Quality Use of Medicines (QUM)?

• The use of the most expensive medicines to ensure high-quality care
• Prescribing drugs primarily based on pharmaceutical marketing materials
• The judicious, appropriate, safe and effective use of medicines to achieve best patient outcomes
• Prioritising medicines for population benefit regardless of individual needs

Correct Answer: The judicious, appropriate, safe and effective use of medicines to achieve best patient outcomes

Q2. Which internationally recognised concept is most closely aligned with QUM?

• Rational use of medicines
• Direct-to-consumer pharmaceutical advertising
• Pharmaceutical product life-cycle management
• Market-driven prescribing

Correct Answer: Rational use of medicines

Q3. Which of the following is NOT a core principle of QUM?

• Evidence-based selection and prescribing
• Patient-centred decision making
• Maximising sales volumes for the healthcare institution
• Regular monitoring and review of therapy

Correct Answer: Maximising sales volumes for the healthcare institution

Q4. The “five rights” of medication administration contribute to QUM. Which one is NOT one of the five rights?

• Right patient
• Right drug
• Right dose
• Right cost

Correct Answer: Right cost

Q5. Which activity is central to ensuring QUM at the point of prescribing?

• Selecting medicines based solely on pharmaceutical brand recognition
• Applying up-to-date clinical evidence and individual patient factors to choose therapy
• Discontinuing monitoring after initial prescription
• Prescribing multiple drugs to prevent any future disease

Correct Answer: Applying up-to-date clinical evidence and individual patient factors to choose therapy

Q6. Which stakeholder is primarily responsible for implementing formulary decisions that promote QUM within a hospital?

• Hospital Pharmacy and Therapeutics (P&T) committee
• Local pharmaceutical sales representatives
• Patients alone
• Medical device manufacturers

Correct Answer: Hospital Pharmacy and Therapeutics (P&T) committee

Q7. Antimicrobial stewardship is an important QUM strategy because it primarily aims to:

• Increase use of broad-spectrum antibiotics indiscriminately
• Reduce antimicrobial resistance and optimise antibiotic use
• Promote antibiotic sales for pharmaceutical profitability
• Eliminate the need for infection control measures

Correct Answer: Reduce antimicrobial resistance and optimise antibiotic use

Q8. In QUM, deprescribing refers to:

• Automatically switching all patients to generic versions
• The planned and supervised process of dose reduction or stopping medicines that are no longer beneficial or are harmful
• Increasing the number of medications to achieve polypharmacy
• Prescribing alternative herbal remedies without evaluation

Correct Answer: The planned and supervised process of dose reduction or stopping medicines that are no longer beneficial or are harmful

Q9. Which measure is commonly used to assess appropriate antibiotic prescribing as part of QUM evaluation?

• Defined Daily Dose (DDD) per 1,000 patient-days
• Number of pharmaceutical advertisements in a hospital
• Total revenue from antibiotic sales
• Patient hair colour distribution

Correct Answer: Defined Daily Dose (DDD) per 1,000 patient-days

Q10. Pharmacovigilance contributes to QUM primarily by:

• Identifying and managing adverse drug reactions to improve safety
• Marketing new off-label uses of medicines
• Replacing clinical trials completely
• Reducing the need for medication counselling

Correct Answer: Identifying and managing adverse drug reactions to improve safety

Q11. Which of the following best exemplifies a person-centred approach in QUM?

• Ignoring patient preferences to follow rigid protocols
• Shared decision-making incorporating patient values, preferences and context
• Prescribing based solely on age without assessment
• Standardised prescribing for every patient with the same diagnosis

Correct Answer: Shared decision-making incorporating patient values, preferences and context

Q12. Clinical guidelines support QUM by:

• Providing evidence-informed recommendations for diagnosis and treatment
• Ensuring every patient receives the most expensive therapy
• Replacing clinician judgment entirely
• Being used only for administrative reporting and not clinical care

Correct Answer: Providing evidence-informed recommendations for diagnosis and treatment

Q13. Which principle emphasises using medicines that provide the greatest health benefit relative to their cost?

• Equity in access
• Cost-effectiveness
• Brand loyalty
• Non-evidence-based prescribing

Correct Answer: Cost-effectiveness

Q14. A medication review conducted by a pharmacist as part of QUM should primarily aim to:

• Increase pill burden to maintain patient dependence
• Identify and resolve medication-related problems and optimise therapy
• Switch all medicines to newer patented products
• Record medication names without assessing appropriateness

Correct Answer: Identify and resolve medication-related problems and optimise therapy

Q15. Equity as a principle of QUM means:

• Providing identical treatment to every patient irrespective of need
• Ensuring fair access to appropriate medicines for all individuals according to need
• Prioritising wealthier populations for newer medicines
• Restricting access to medicines to reduce costs only

Correct Answer: Ensuring fair access to appropriate medicines for all individuals according to need

Q16. Which tool supports prescribers to align with QUM by providing dosing, interactions and contraindication information at the point of care?

• Clinical decision support systems (CDSS)
• Pharmaceutical brochure rack
• Unregulated social media posts
• Generic patient billing software

Correct Answer: Clinical decision support systems (CDSS)

Q17. Which indicator most directly assesses patient adherence as part of QUM monitoring?

• Medication possession ratio (MPR) or proportion of days covered (PDC)
• Number of formulary exclusions
• Number of clinical practice guidelines published
• Total hospital bed occupancy rate

Correct Answer: Medication possession ratio (MPR) or proportion of days covered (PDC)

Q18. In the context of QUM, therapeutic substitution refers to:

• Replacing a prescribed medicine with a therapeutically equivalent but usually less costly alternative
• Substituting patient counselling with written leaflets only
• Changing a medicine for one with completely different mechanism without clinical rationale
• Automatically switching from generic to brand-name products

Correct Answer: Replacing a prescribed medicine with a therapeutically equivalent but usually less costly alternative

Q19. Which policy intervention is likely to improve QUM at a national level?

• Implementing evidence-based national essential medicines lists and treatment guidelines
• Removing regulations on pharmaceutical promotion
• Providing unconditional subsidies for all medicines regardless of need
• Discouraging pharmacovigilance reporting to reduce administrative work

Correct Answer: Implementing evidence-based national essential medicines lists and treatment guidelines

Q20. Which outcome is a direct goal of QUM implementation in clinical practice?

• Maximising adverse drug reactions to enhance pharmacovigilance data
• Optimising therapeutic outcomes and minimizing harm from medicines
• Increasing polypharmacy across all age groups
• Ensuring that only new medicines are used

Correct Answer: Optimising therapeutic outcomes and minimizing harm from medicines

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