Evaluation of drug services based on prescription indicators and patient care according to WHO at the hospital General Practitioner (GP) outpatient clinic in Depok, Indonesia

  • Nadia Farhanah Syafhan Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
  • Hindun Wilda Risni Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
  • Azzahra Fahira Salsabila Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
  • Raden Jacinda Yasmin Purnama Putri Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
  • Marchen Prasetyaningrum Unit of Pharmacy and Central Sterile Supply Department, Universitas Indonesia Hospital, Depok 16424, West Java, Indonesia

Abstract

The World Health Organization (WHO) has developed prescription and patient care indicators, accompanied by optimal benchmarks, aimed at promoting the rational and optimal medicine use. This study seeks to evaluate drug services utilizing WHO prescription and patient care indicators at the hospital General Practitioner (GP) outpatient clinic. The research was conducted retrospectively for prescription indicators, covering all prescriptions issued from January to December 2022, involving 1505 prescriptions with total 4647 drug items prescribed for 804 patients. Prospective data collection was employed using consecutive sampling to evaluate patient care from April to May 2023. Evaluation of WHO prescription indicators yielded the following results: the average number of drugs prescribed per patient was 3.09 ± 1.998; the percentage of drug prescribed by generic drug names was 47.47%; the percentage of antibiotic prescriptions was 5.46%; the percentage of injectable drug prescriptions was 6.80%; and the percentage of prescriptions in accordance with the national formulary was 75.91%. The percentages of antibiotic and injectable drug prescriptions met the optimal WHO prescription values. In terms of patient care, the results showed that the average medical consultation time was 12.44 ± 8.1 minutes; the average of drug dispensing time was 45.65 ± 28.8 minutes; the percentage of appropriate drug dispensed was 96.25%; the percentage of adequate drug labelling was 100%; and the percentage of patient knowledge was 78.78%. Age (p=0.111) and gender (p=0.075) showed no significant correlation with patient knowledge. However, there was a significant relationship between education level (p=0.014) and patient knowledge. Prescription and patient care indicators are aspects of improvement to meet the optimal benchmarks according to WHO standards.

References

[1] F. D. Sema, E.D. Asres, and B.D. Wubeshet, “Evaluation of Rational Use of Medicine Using WHO/INRUD Core Drug Use Indicators at Teda and Azezo Health Centers, Gondar Town, Northwest Ethiopia,” Integrated Pharmacy Research & Practice, 10, 51–63, 2021. https://doi.org/10.2147/IPRP.S316399

[2] S.G. Tassew, H.N. Abraha, K. Gidey, & A. Gebre, “Assessment of drug use pattern using WHO core drug use indicators in selected general hospitals: a cross-sectional study in Tigray region, Ethiopia,” BMJ Open, 11(10),e045805, 2021. https://doi.org/10.1136/bmjopen-2020-045805

[3] M. Atif, M.R. Sarwar, M. Azeem, M. Naz, S. Amir, & K. Nazir, “Assessment of core drug use indicators using WHO/INRUD methodology at primary healthcare centers in Bahawalpur, Pakistan,” BMC health services research, 16(1), 684, 2016. https://doi.org/10.1186/s12913-016-1932-2

[4] WHO, “Promoting rational use of medicines: core components. WHO Policy Perspectives on Medicines,” 2016 https://apps.who.int/iris/bitstream/handle/10665/67438/WHO_EDM_2002.3.pdf (Published online 2002:1-6.)

[5] L. Scott, “Medication errors. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 30(35), 61–62, 2016. https://doi.org/10.7748/ns.30.35.61.s49

[6] F. Yuliastuti, A. Purnomo, R. Sudjaswadi, “Analisis Penggunaan Obat Pada Pasien Rawat Jalan Di Rumah Sakit Umum Daerah Sleman Yogyakarta Periode April 2009,” Media Farmasi, 10(2): 104-113, 2013. http://doi.org/10.12928/mf.v10i2.1177

[7] O.A. Akl, A.A. El Mahalli, A.A. Elkahky, A.M. Salem, “WHO/INRUD drug use indicators at primary healthcare centers in Alexandria, Egypt,” Journal of Taibah University Medical Sciences, 9(1): 54-64, 2014. https://doi.org/10.1016/j.jtumed.2013.06.002

[8] M. Wei, N. Yang, F. Wang, G. Zhao, H. Gao, Y. Li, “Epidemiology of Coronavirus Disease 2019 (COVID-19) Caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)”. Disaster medicine and public health preparedness, 14(6), 796–804, 2020. https://doi.org/10.1017/dmp.2020.155

[9] L. Melku, M. Wubetu, & B. Dessie, B. (2021). Irrational drug use and its associated factors at Debre Markos Referral Hospital's outpatient pharmacy in East Gojjam, Northwest Ethiopia”. SAGE open medicine, 9, 2021. 20503121211025146. https://doi.org/10.1177/20503121211025146

[10] R. Govindaraj, M.R. Reich, J.C. Cohen, “ World Bank Pharmaceuticals - HNP Discussion Paper,”2000.

[11] WHO, “How to investigate drug use in health facilities. Selected drug use indicators,” Health Policy (New York), 34(1), 1993. https://doi.org/10.1016/0168-8510(95)90068-3

[12] B.D. Mekonnen, M.Z. Ayalew, & A.A. Tegegn, “Rational Drug Use Evaluation Based on World Health Organization Core Drug Use Indicators in Ethiopia: A Systematic Review,” Drug, healthcare and patient safety, 13, 159–170, 2021. https://doi.org/10.2147/DHPS.S311926

[13] M. Sisay, G. Mengistu, B. Molla, F. Amare, & T. Gabriel, “Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study,” BMC health services research, 17(1), 161, 2017. https://doi.org/10.1186/s12913-017-2097-3

[14] K. Diana, A. Kumala, N. Nurlin, M.R. Tandah, “Evaluasi Penggunaan Obat Berdasarkan Indikator Peresepan dan Pelayanan Pasien di Rumah Sakit Tora Belo,” Jurnal Farmasi dan Ilmu Kefarmasian Indonesia, 7(1SI): 13–19, 2021. https://doi.org/10.20473/jfiki.v7i1SI2020.13-19

[15] I. Masturoh, & T.N. Anggita, Vol 4. 1st ed., Metodologi Penelitian Kesehatan. Jakarta: Kementerian Kesehatan RI, 2018.

[16] S.M. Dahlan, Edisi 4., Statistik Untuk Kedokteran dan Kesehatan: Deskriptif, Bivariat, dan Multivariat Dilengkapi Aplikasi SPSS. Jakarta: Salemba Medika, 2009.

[17] A. Zulkarnaini, R.D. Martini, “Gambaran Polifarmasi Pasien Geriatri Dibeberapa Poliklinik RSUP Dr. M. Djamil Padang,” Jurnal Kesehatan Andalas, 8(1S): 1, 2019. https://doi.org/10.25077/jka.v8i1S.916

[18] M. Herr, N. Sirven, H. Grondin, S. Pichetti, & C. Sermet, “Frailty, polypharmacy, and potentially inappropriate medications in old people: findings in a representative sample of the French population,” European journal of clinical pharmacology, 73(9), 1165–1172, 2017. https://doi.org/10.1007/s00228-017-2276-5

[19] F. Yusuf, “Studi Perbandingan Obat Generik dan Obat Dengan Nama Dagang,” Jurnal Farmanesia, 9(11): 5-10, 2016.

[20] R. Meenakshi, N. Selvaraj, N. Anandabaskar, A. Dhamodharan, A.K. Badrinath, & M.A. Rajamohammad,
“Prescription audit of a teaching hospital in South India using World Health Organization core prescribing indicators - A cross-sectional study,” Perspectives in clinical research, 13(3), 132–136, 2022. https://doi.org/10.4103/picr.PICR_172_20

[21] S. Kurniasari, F. Humaidi, I. Sofiyati, “Penggunaan Antibiotik Oleh Penderita Infeksi Saluran Kemih Di Instalasi Rawat Inap (IRNA) 2 RSUD Dr. H. Slamet Martodirdjo Pamekasan Tahun 2018,” Jurnal Ilmiah Farmasi Attamru, 1(1): 15-27, 2020. https://doi.org/10.31102/attamru.v1i1.918

[22] R. Septiana, & K. & Khusna, “Gambaran Penggunaan Antibiotik Tanpa Resep di Apotek X Kabupaten Sragen,” Jurnal Dunia Farmasi, 5(1): 13-20, 2020. https://doi.org/10.33085/jdf.v5i1.4750

[23] A.D. Kristiyowati, “Rasionalitas Penggunaan Obat Ditinjau Dari Indikator Peresepan World Health Organization (Who) Di Rumah Sakit IMC Periode Januari - Maret 2019,” 2020.

[24] F.S. Teni, B.L. Wubishet, D.K. Yimenu, “Systematic review and meta-analysis of medicine use studies in Ethiopia using the WHO patient care indicators with an emphasis on the availability of prescribed medicines,” BMJ Open, 12(3): 1-15, 2022. https://doi.org/10.1136/bmjopen-2021-054521

[25] I. Andhyka, H. Adisaputra, L. Hidayatullah, “Profil Waktu Tunggu Pelayanan Resep Rawat Jalan Di RSUD Kota Mataram Tahun 2018,” Jurnal Ilmu Kesehatan dan Farmasi, 7(1): 49-52, 2019. https://doi.org/10.51673/jikf.v7i1.577

[26] M. Atif, S. Scahill, M. Azeem, M.R. Sarwar, Z.U.D. Babar, “Drug utilization patterns in the global context: A systematic review,” Health Policy Technol 6(4): 457-470, 2017. https://doi.org/10.1016/j.hlpt.2017.11.001

[27] T. Gudeta, & D. Mechal, “Patient Knowledge of Correct Dosage Regimen; The Need for Good Dispensing Practice,” Journal of primary care & community health, 10, 2019. https://doi.org/10.1177/2150132719876522

[28] B. Mathew, R. Gadde, P. Nutakki, H. Doddayya, “Assesment of Drug Dispensing Practices Using WHO Patient Care and Health Facility Indicators in a Private Tertiary Care Teaching Hospital,” International Journal of Pharmacy and Pharmaceutical Sciences, 5(4): 368-371, 2013.

[29] D.A. Nugraheni, & N. Pudiarifanti, “Perbandingan Dispensing Time dan Pengetahuan Pasien Berdasarkan Indikator WHO Di Puskesmas Kabupaten Sleman,” Media Farmasi: Jurnal Ilmu Farmasi, 16(2): 88, 2019. https://doi.org/10.12928/mf.v16i2.13988

[30] Dahlan, 6th ed., Statistik Untuk Kedokteran Dan Kesehatan: Deskriptif, Bivariat, Multivariat. Jakarta: Epidemiologi Indonesia, 2014.

[31] E.N. Sari, “Evaluasi Pelayanan Obat Berdasarkan Indikator Pelayanan Pasien World Health Organization di Puskesmas Seyegan,” Thesis, Study Program of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Islam Indonesia, Yogyakarta, Indonesia, 2020.

[32] E. Wikan, F. Rahmawati, I.A. Wahab, “Kepatuhan Penggunaan Obat pada Komunitas Pasien Lanjut Usia Dengan Penyakit Kronis di Kecamatan Muntilan Jawa Tengah,” Majalah Farmaseutik, 17(1): 54, 2021. https://doi.org/10.22146/farmaseutik.v17i1.49088

[33] E.A. Payung, & S. Mambela, “Pengaruh Usia Dan Tingkat Pendidikan Terhadap Pemahaman Pasien Setelah Pelayanan Informasi Obat Di Puskesmas Makale Kabupaten Tana Toraja Tahun 2018,” Media Farmasi, 14(2): 21, 2018. https://doi.org/10.32382/mf.v14i2.586
Published
2025-04-30
How to Cite
SYAFHAN, Nadia Farhanah et al. Evaluation of drug services based on prescription indicators and patient care according to WHO at the hospital General Practitioner (GP) outpatient clinic in Depok, Indonesia. JURNAL ILMU KEFARMASIAN INDONESIA, [S.l.], v. 23, n. 1, p. 18-28, apr. 2025. ISSN 2614-6495. Available at: <http://jifi.farmasi.univpancasila.ac.id/index.php/jifi/article/view/1609>. Date accessed: 04 may 2025. doi: https://doi.org/10.35814/jifi.v23i1.1609.