KEY FACTORS FOR SUSTAINABLE RATIONAL USE OF MEDICINE PROGRAM IN GUNUNGKIDUL AND SLEMAN DISTRICTS, INDONESIA


Sunartono H, Prabandari Ys, Kusnanto H, Suryawati S

Abstract


 Objective: Many of the rational use of medicines (RUM) interventions have been proven effective in improving medicine use, but the impacts were usually not sustainable for longer period of time. Gunungkidul and Sleman Districts of Indonesia have succeeded in implementing RUM program for more than two decades. This is considered rare, and therefore, it is important to identify factors contributing to the success.

Methods: This is a single case study with non-experimental exploratory design. Quantitative and qualitative data were collected integratively to obtain information concerning the indicators and the process of RUM implementation. Quantitative data were collected in reference to the World Health Organization (WHO) 1993 RUM indicators, including average number of medicines per prescription (polypharmacy), percentage of patients receiving antibiotics, and percentage of patients receiving injections. Qualitative data were analyzed descriptively and were arranged chronologically in respective to each district.

Results: Implementation of RUM in the two districts has successfully lasted up to 20 years. The annual medicine use indicators from 1994 to 2014 in Gunungkidul District show that polypharmacy decreased from 4.2 to 2.89, percentage patients receiving injections declined from 68.05% to 0%, and percentage of patients receiving antibiotics improved from 52.1% to 24.1%. The same indicators in Sleman District show that, between 1998 and 2014, polypharmacy remained stable at 3, percentage of patients receiving injections declined from 4.9% to 0.18%, and percentage of patients receiving antibiotics improved from 44.31% to 20%. Culturization of RUM program is the main key for sustainable impacts. Another important key is the high commitment of health policymakers to implement the principles of evidence-based treatment.

Conclusions: The culturization of RUM program followed by continuous monitoring and evaluation by district health managers were the key factors to maintain the impact of the intervention.


Keywords


Rational use of medicines, Culturization, Program implementation, Sustainability.

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About this article

Title

KEY FACTORS FOR SUSTAINABLE RATIONAL USE OF MEDICINE PROGRAM IN GUNUNGKIDUL AND SLEMAN DISTRICTS, INDONESIA

Topics

Medical doctor

Keywords

Rational use of medicines, Culturization, Program implementation, Sustainability.

DOI

10.22159/ajpcr.2018.v11i2.22653

Date

01-02-2018

Additional Links

Manuscript Submission

Journal

Asian Journal of Pharmaceutical and Clinical Research
Vol 11 Issue 2 February 2018 Page: 132-137

Print ISSN

0974-2441

Online ISSN

2455-3891

Statistics

64 Views | 56 Downloads

Authors & Affiliations

Sunartono H
Division of Clinical Pharmacology and Medicine Policy, Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Indonesia

Prabandari Ys
Department of Health Policy and Management, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Indonesia

Kusnanto H
Department of Health Policy and Management, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Indonesia

Suryawati S
Division of Clinical Pharmacology and Medicine Policy, Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Indonesia


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