ASSESSMENT OF THE RATIONAL USE OF MEDICINES: PRESCRIBING PATTERNS AND INDICATORS AT PUBLIC PRIMARY HEALTH CARE CENTER AND HOSPITAL IN INDONESIA

Abstract

Drug use is one part of drug management cycle which covers selection, procurement, distribution, and use. This study aimed to assess drug prescription pattern using WHO prescribing indicator at primary healthcare centers and public hospital in Indonesia. A cross-sectional study was conducted with the study samples of 2,401 prescriptions from public primary healthcare centers and 1,218 prescriptions from public district hospital in the period of year 2012 – 2016. The average number of drugs prescribed per encounter at primary healthcare center and hospital settings were upon WHO standard, indicating the worse practices. At primary healthcare setting, the percentages of drugs prescribed by generic name and the percentages of encounters in which an injection were the same with WHO standards. The percentages of encounters in which an injection is prescribed at hospital setting was also inline with WHO standard. The percentage of encounters in which an antibiotic is prescribed at primary healthcare center was below WHO standard and in contrast at hospital setting was upon WHO standard. The percentage of drugs prescribed from formulary at primary healthcare center and hospital settings were almost achieve WHO standard. In general, the prescribing practices tended to show better pattern by time. The most problem of prescribing practices from this study was the high average number of drugs prescribed per encounters which leads to polypharmacy. The other problems were the low percentage of drugs prescribed by generic name and high percentage of encounters with antibiotic, particularly at hospital setting.