Peningkatan Mutu Penggunaan Obat di Puskesmas Melalui Pelatihan Berjenjang Pada Dokter dan Perawat = Improving the Quality of Prescribing at Primary Health Centres Through a Training Intervention for Doctors and ...

Background: inappropriate use of drugs for the treatment of acute respiratory infections (ARI) has been reported worldwide. Patients present at health centres are commonly prescribed with unnecessary antibiotics. Inappropriate prescribing may result in the occurrence of adverse drug event. Objective: this study aims (1) to assess prescribing pattern for ARI and muscle ache (myalgia) at health centres in 8 districts of West Sumatra Province, and (2) to improve quality of prescribing for ARI and muscle ache in health centres. Method: A cross sectional study was carried out to address objective (1). Drug use data were collected retrospectively at health centres in 8 districts of West Sumatra Province for baseline information on prescribing. To address objective (2) a training intervention on rational use of drugs was carried out, involving primary health care (PHC) physicians and paramedics from 15 randomly selected primary health centres. Training was characterized as motivational, interactive, problem-based approach for both doctors and paramedics, and on the job training for paramedics. Result: Forty three health centres participated in the study. The average number of drugs prescribed for children with ARI was similar to that prescribed by paramedics. i.e. 3.62 and 3.69 respectively. Patients present at health centres with muscle ache received an average of 3.24 drugs. Antibiotic prescribing in several districts accounted for more than 90%. Only a few health centres reported the use of antibiotics of less than 70%. Six months after training intervention on rational use of drugs for PHC physicians and paramedics, the use of drugs including antibiotics and injection decreased significantly. The average number of drugs for children with ARI decreased from 3.74 + 0.58 to 2.47 + 0.67 (