Kajian perbandingan penggunaan ubat-ubatan di Malaysia dan Indonesia : kajian kes di Kelantan dan Aceh
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Date
1994
Authors
Hamid, Achmad Farhan
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Abstract
Drug utilization study is important in establishing the status of drug use in a
particular country. In this study several aspects of drug use in Malaysia and Indonesia
has been accomplished. A comparison was carried out at a university hospital and a
district hospital in both countries.
The objective of the study is to identify the following aspects of drug utilization : ·
i) the pattern of outpatient prescription at a university hospital and a district hospital in
Malaysia and Indonesia, ii) prescribing habits at the university hospital and district
c'
hospital in Malaysia and Indonesia, iii) the impact of counselling on patient drug
compliance, iv) the factors which affect patient drug compliance from both the urban
and rural areas in Malaysia and Indonesia, v) comparison of drug cost between Malaysia
and Indonesia, and vi) prescribing practice of the private sector in Malaysia.
To meet the above objective, twenty per cent of outpatient prescription were
collected for one year from the pharmacy departments of each hospital. Seven hundred
and sixty nine outpatients from four districts in both countries were interviewed to
assess patient drug compliance. A separate group of 357 outpatients in t\VO districts in
Malaysia have been counselled and followed by an interview about drug compliance. A
study on the prescribing practice were carried out on 48 medical doctors· at the
university hospitals and district hospitals. The cost comparison of 113 drug items in
Malaysia and Indonesia to establish cost ratios were determined. Prescribing practice of
the private sectors conducted in Malaysia was established through simulation
case-studies based on diarrhea as well as cough & cold.
To assist the drug utilization studies, specifically for the outpatient drug
prescriptions study, an application software using the personal computer was developed.
Tests for determining the accuracy and efficiency of the application were successfully
carried out.
The results showed :
i) In the outpatient prescriptions a significant difference (p<0.01) between the
university hospitals and the district hospitals in each country A significant difference
was also found between the university hospitals and the district hospitals of both
countries. In all cases, the sample considered was taken from the general public,
pediatric as well as geriatric outpatients.
ii) Prescribing practice at the university hospitals and district hospitals in both
countries showed a similarity with respect to : the average time spent in examining
patients which is less than 10 minutes, prescription \Vith more than one kind of drug, and
the sources of drug use information. A difference noted was that the doctors in
Indonesia practised the essential drug concept as compared to their counterparts in
Malaysia.
iii) It was concluded in this study that counselling can increase patient drug
compliance. Patient drug compliance was signiticantly different (p<O.Ol) between the
counselled and the non-counselled group.
iv) Of the three factors tested, factors of drug and patient's age were found ~o
affect patients compliance. However, there were inconsistencies in the results of drug
compliance o~tained from patients who were not receiving counselling in both mral and
urban areas. In Malaysia the compliance in rural areas was more significant compared
with urban areas. and in Indonesia it was found to be the reverse.
v) One interesting finding in this study showed that the average cost of drugs in
Indonesia is more expensive than Malaysia by a ratio of 1.46 to 1.
vi) In general, the prescribing practice in private clinics in Malaysia was not
rational. This was evident when antibiotics were prescribed for more than three quarter
of the cough & cold simulation cases; and about one fifth of the diarrhea simulation
cases. Direction of use of drugs as well as drug information given either by the medical
clinics or the private pharmacy outlets do not meet the minimum requirement agreed
upon by international concensus.
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Keywords
Penggunan Ubat-ubatan