FAKTOR PENDORONG PERESEPAN RACIKAN UNTUK PASIEN ANAK RAWAT JALAN

Background: Drug dosage forms suitable for pediatric usually are not available in health cares. Physicians usually prescribe extemporaneous compounding dosage forms to solve the problems. Although the compounding has some benefits, risks may arise when using the medicines. Evaluation of factors contributed to prescribe the compounding was needed in order to improve the use of medicines for children. Objectives: The study was to identify factors influencing physicians� decision to prescribe extemporaneous compounding using Theory of Planned Behavior (TPB). Method: The study was conducted in three phases. The first phase was using interview method to elicit participants� belief about compounding and the reasons of prescribing compounding. The second phase was questionnaire development and evaluation based on the TPB model. The third phase was survey using the TPB questionnaire to predict dominant factor influencing physicians� decision to prescribe compounding. Participants of 249 physicians from Yogyakarta completed the questionnaire. The data were analyzed with multiple linear regressions.  Results: The elicitation study showed that factors influencing compounding prescribing could be categorized to therapy-related factors, healthcare system factors, patient factors and past experiences. A number of opinions about compounding prescription involved effectiveness, legality, drug interactions and dosage regimen. Problems related to compounding preparation in pharmacies were conformity between prescription and the resulting product, hygiene, compounding guideline, as well as competency of compounding technicians. In general, the questionnaire to measure factors that influence physicians� decision to prescribe compounding medicine for pediatric patients based on TPB model was valid. Attitude had the strongest impact on intentions based on their beliefs toward the benefits of the compounding. The past experiences added to the model increased effect on the intention. Conclusion: The current study provides information about the process underlying the decision to prescribe compounding for pediatric outpatients. The use of TPB model provided a clear picture that attitude was the dominant factor influencing compounding prescription. The addition of the experience factor was very important in studying the prescribing intention