THE RELATIONSHIP BETWEEN THE HEALTH BELIEF MODEL AND DRUG INFORMATION SERVICES PROVIDED BY PHARMACISTS TO PREGNANT AND BREASTFEEDING WOMEN

ABSTRACTThe use of medication during pregnancy and breastfeeding cannot be avoided, particularly for those with chronic diseases. The use of medication for these patients require special attention, especially by pharmacists as they have the responsibility to provide medications and appropriate services to achieve optimal therapeutic goals. The drug information service actively provided by pharmacists is a display of their commitment in preventing drug therapy problems and improving the quality of life of pregnant and breastfeeding women. This study aimed to analyze the relationship between pharmacists' beliefs based on the Health Belief Model (HBM) approach and the practice of active drug information service for pregnant and breastfeeding women with chronic diseases. This study was an observational study with a cross-sectional design and used a self-administered questionnaire. 62 pharmacists in Primary Healthcare Centers in Surabaya agreed to participate in this study. The Spearman correlation analysis was used and showed that perceived self-efficacy had the strongest relationship (rs = 0.357) with the practice of providing active drug information. Thus, it can be concluded that perceived self-efficacy is a factor that is directly related to the practice of providing active drug information.Keywords: Active Drug Information Services, Health Belief Model, Pharmacists

The Evolution of Drug Information Services to Asynchronous Delivery of Pharmacist eConsults

Drug information (DI) services provided an avenue to expand the role of pharmacists as the medication experts. The focus of DI has shifted from general questions submitted to DI centers to patient-specific questions that optimize care. One method to increase access to pharmacist expertise is through pharmacy eConsults. Pharmacy eConsults provide specialist care for medically complex patients using a patient-centered, asynchronous approach. The purpose of this article is to describe the evolution of consults from formal drug information services and describe one academic medical center’s implementation of a pharmacy eConsult service to provide patient-specific DI.

ANALISIS PELAYANAN INFORMASI OBAT (PIO) PADA PASIEN DI APOTEK X PERIODE MEI 2021

Drug Information Service is an activity of providing and providing information, drug recommendations that are independent, accurate, unbiased, current and comprehensive carried out. The purpose of this study was to analyze the description of drug information services received by patients. This research method is descriptive with accidental sampling technique based on a survey with a sample of 62 respondents. The results of the questionnaire given to patients regarding drug information services were obtained regarding the provision of drug information through leaflets or brochures as much as 22.58% were always carried out; information related to drug names as much as 80.65% is always carried out; drug dosage forms (tabelts, capsules, syrups, creams, ointments, etc.) as much as 82.26% are always carried out; drug doses as much as 77.42% are always carried out; how to use drugs as much as 85.48% are always done; the method of storing drugs as much as 80.65% is always carried out; drug indications as much as 72.58% are always carried out; drug interactions as much as 75.81% are always carried out; prevention of drug interactions as much as 74.19% is always done; drug side effects as much as 79.03% are always carried out; the method of destroying drugs (throwing, burning, or burying) 9.68% is always done. It's just that in drug information services regarding the provision of leaflets or brochures the results are 22.58% and the method of destroying drugs is 9.68%, which means that pharmacists rarely provide information and education to patients at the pharmacy about giving leaflets or brochures and how to destroy drugs. ABSTRAKPelayanan Informasi Obat merupakan kegiatan penyediaan dan pemberian informasi, rekomendasi obat yang independen, akurat, tidak bias, terkini dan komprehensif. Tujuan penelitian ini menganalisis mengidentifikasi gambaran pelayanan informasi obat yang di terima oleh pasien di Apotek X. Metode penelitian ini yaitu deskriptif dengan teknik accidental sampling berdasarkan survei dengan sampel yang didapat yaitu 62 responden. Hasil penelitian dari kuisioner yang diberikan pada pasien mengenai pelayanan informasi obat didapatkan mengenai pemberian informasi obat melalui leaflet atau brosur sebanyak 22,58% selalu dilakukan; informasi terkait nama obat sebanyak 80,65% selalu dilakukan; bentuk sediaan obat (tabelt, kapsul, sirup, cream, salep, dll) sebanyak 82,26% selalu dilakukan; dosis obat sebanyak 77,42% selalu dilakukan; cara pemakaian obat sebanyak 85,48% selalu dilakukan; cara penyimpanan obat sebanyak 80,65% selalu dilakukan; indikasi obat sebanyak 72,58% selalu dilakukan; interaksi obat sebanyak 75,81% selalu dilakukan; pencegahan terhadap interaksi obat sebanyak 74,19% selalu dilakukan; efek samping obat sebanyak 79,03% selalu dilakukan; cara pemusnahan obat (dibuang, dibakar, atau dikubur) sebanyak 9,68% selalu dilakukan. Hanya saja pada pelayanan informasi obat mengenai pemberian leaflet atau brosur hasilnya 22,58% dan cara pemusnahan obat hasilnya 9,68% yang artinya masih jarang dilakukannya pemberian informasi dan edukasi oleh Apoteker kepada pasien di Apotek tersebut tentang pemberian leaflet atau brosur dan cara pemusnahan obat.

The Effects of Counseling and Drug Information Services by Pharmacist to Medication Adherence and Therapy Outcomes on Sciatica Patients at Dr. Suyoto Hospital, Jakarta

People suffered from sciatica, pain along the sciatic nerve, require therapy up to 4 months or longer to achieve controlled-pain. The main treatment for sciatica is physiotherapy; medication is only secondary therapy. This quasi-experimental study aimed to investigate the effects of counseling and drug information services (DIS) by pharmacist on medication adherence and duration of therapy. In the study conducted in March‒July 2018, 128 ambulatory sciatica patients newly diagnosed at Dr. Suyoto Hospital, Jakarta, were divided randomly into two groups, each of 64 patients. The intervention group was given counseling and DIS by clinical pharmacists (3 times with interval of 4 weeks) as well as brochures. Primary data on medication adherence were obtained prospectively through interviews using a validated questionnaire, before the intervention and 4 weeks after the last counseling and DIS by clinical pharmacists. Secondary data (up to 16 weeks), including pain scores, were obtained from medical records and the patient administrative data. The results showed that sociodemographic characteristics as well as distribution of initial adherence and initial pain levels of the two groups were not significantly different (Mann-Whitney test, p>0.05). After the last intervention, the proportion of patients with high-adherence in the intervention group (12.5%) was higher than in the control group (6.3%), as was the proportion of patient achieved controlled-pain (84.4% versus 76.6%). The results of survival analysis showed that the duration of treatment by which 50% of patients achieved controlled-pain (median survival) was significantly shorter in the intervention group (85 days) than in the control group (92 days), while the probability of achieving controlled-pain (hazard ratio) in the intervention group was 1.7 times of that in the control group. In conclusion, counseling and DIS by pharmacist can improve the effectiveness of sciatica treatment, although the main therapy for the nerve pain is not medication.

Impact of Drug Information Services on Promotion of Rational Use of Antimicrobial Agents: A Descriptive Retrospective Study

Introduction: Drug Information Services (DIS) is dedicated to provide information about drugs and pharmacotherapy, on request from health care professionals, organisations or patients. World Health Organisation (WHO) recommends DIS to promote rational use of medicines. Aim: The study was done to understand the impact of DIS on promotion of rational use of antimicrobial agents, at a tertiary care hospital. Materials and Methods: In this retrospective descriptive study, 126 cases with infection related medication issues requiring opinion related to appropriate antimicrobial therapy from January 2014-June 2018 were included and studied in September 2018. Data related to culture/susceptibility results, treatment offered, reason for referral and suggestions given by the DIS captured in the case details form were analysed. The number of antimicrobials prescribed per case before and after DIS opinion was compared using paired t-test. Results: Of the 126 cases (mean age: 35±18.2 years), 82 were culture positive, of which 43 samples reported Multi-Drug Resistant (MDR) organisms. Of 126 case referrals, 53 (42.1%) were regarding opinion on appropriate antimicrobial therapy, 18 (14.3%) for suspected ADRs and rechallenge opinion, 27 (21.5%) for dosage adjustment of antimicrobials and 12(9.5%) for suspected drug-drug interactions. Based on DIS recommendations, mean number of antimicrobials prescribed per patient reduced from 3.4±1.85 to 1.62±1.38 (p<0.0001) when tested by paired t-test. Sixteen culture-negative cases were referred for opinion on appropriate antimicrobial therapy. Conclusion: DIS is a very useful resource, which provides unbiased, factual drug information to clinicians and patients and must be established in all healthcare facilities. DIS strengthen rational use of antimicrobials.

PENGUKURAN KINERJA INSTALASI FARMASI RUMAH SAKIT ADVENT MANADO DENGAN METODE BALANCED SCORECARD PADA PERSPEKTIF KEUANGAN DAN PERSPEKTIF PROSES BISNIS INTERNAL

ABSTRACTHospital Pharmacy Installation (HPI) was a medical support service that was required to provide quality pharmaceutical services to the public, so it requires performance measurement. The purpose of this study was to determined the performance of HPI Advent Manado using the Balanced Scorecard (BSC) method through a financial perspective and an internal business process perspective. This research was a non-experimental, descriptive type of research with retrospective and prospective data collection in the form of primary data and secondary data. The results showed the performance of HPI Advent Manado from a financial perspective in 2019 obtained an Inventory Turn Over Ratio (ITOR) value of 5.53 times and a Gross Profit Margin (GPM) of 22.24%. Internal business process perspective with dispensing time for non-concocted prescriptions 14.47 minutes and concocted prescriptions 28.19 minutes, drug availability 93.30% and drug information services stilled not meeting the standards of Permenkes No.72 of 2016. From the research results it can be concluded that the performance of HPI Advent Manado using the BSC method shows a fairly good performance from a financial perspective, although there was still needed for improvement in the ITOR value, and the internal business process perspective has shown good performance and there was still needed for improvements in drug information services. Keywords: Performance measurement, Pharmaceutical installation hospital, Balanced scorecard, Financial perspectives, Internal Business perspectives ABSTRAKInstalasi Farmasi Rumah Sakit (IFRS) merupakan pelayanan penunjang medis yang dituntut memberikan pelayanan kefarmasian yang berkualitas kepada masyarakat, sehingga memerlukan pengukuran kinerja. Tujuan penelitian ini untuk mengetahui kinerja IFRS Advent Manado dengan metode Balanced Scorecard (BSC) melalui perspektif keuangan dan perspektif proses bisnis internal. Penelitian merupakan jenis penelitian non eksperimental bersifat deskriptif dengan pengumpulan data secara retrospektif dan prospektif berupa data primer dan data sekunder. Hasil penelitian menunjukkan kinerja IFRS Advent Manado pada perspektif keuangan tahun 2019 memperoleh nilai Inventory Turn Over Ratio (ITOR) sebesar 5,53 kali dan Gross Profit Margin (GPM) sebesar 22,24%. Perspektif proses bisnis internal dengan dispensing time untuk resep non racikan 14,47 menit dan resep racikan 28,19 menit, ketersediaan obat 93,30% dan pelayanan informasi obat masih belum memenuhi standar Permenkes No.72 tahun 2016. Dari hasil penelitian dapat disimpulkan bahwa kinerja IFRS Advent Manado dengan metode BSC menunjukkan kinerja yang cukup baik dari perspektif keuangan, walaupun masih perlu upaya perbaikan pada nilai ITOR, dan perspektif proses bisnis internal sudah menunjukkan kinerja baik dan masih perlu adanya perbaikan pada pelayanan informasi obat.Kata kunci: Pengukuran Kinerja, IFRS, Balanced Scorecard, perspektif keuangan, perspektif proses bisnis internal

AN OVERVIEW OF DRUG INFORMATION CENTER – FUNCTIONS AND CHALLENGES IN INDIA

Drug information has been providing data on drugs that are being used in the health-care system. It also bears dosing, adverse drug reactions (ADRs), side effects, pharmacokinetic parameters and educating the health-care professionals and managing drug shortage, identifying alternative treatments, and developing alternative protocols for restrictive use. The Moto of drug information is to contribute genuine, precise, appropriate, impartial drug information to the patients, nursing staff, practicing physician, pharmacist, and other health-care professional. Drug information regularly responds to inquiries from patients, health-care professionals. The drug information center routinely receives queries from hospital staff, patients, and responds to queries regarding ADRs, drug interactions, pharmacokinetic parameters of drugs, and information on new drugs available in the market. Drug information services help in improving patient safety, minimizing drug-related issues to the patient, and rational use of drugs by both physician and patient. Drug information services are providing unambiguous data with a well-trained and registered clinical pharmacist. Most of the developed countries are using this service successfully. In well-developed countries, these centers provide accurate and up to date drug information to health-care professionals within minutes. However, developing countries like India need to pay more attention to the services. Information present in this paper not only enlightens the drug information services but also on the future aspects that need to be taken.

Decentralize-Change-Recentralize Model of Drug Information Networks in Health Centers: Decentralized Drug Information Services

Large health centers usually decentralize their services to small self-sufficient sub-centers of care delivery. These small centers are part of an extensive network of practitioners who are connected. The drug information services of independent clinical pharmacists in a health center could be fragmented. Drug information centers thus need to have a new definition of the mode of operation. While maintaining autonomy in information exchange, professionals are integrated to form a large community of practitioners. Technological advancements in communication and access to resources enable efficient collaborations to happen. Immersed in patient-centered collaborative practice environments, networks of professionals integrate drug information services. Drug information networks thus hold a similar philosophy of health centers to decentralize-change-centralize its services. Further research is required to measure the impact of this model of drug information services. Article Type: Commentary