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.