Consumer Perspectives on Rational use of Medicine (RUM) Purnawan Junadi FKMUI, 2018

Transkripsi

1 Consumer Perspectives on Rational use of Medicine (RUM) Purnawan Junadi FKMUI, 2018

2 Rational Use of Drugs or Medical Resources? RUD/RUM: "Patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community." (WHO, 1985) RUMR: Patients/ Communities receive any medical intervention for diagnosis and treatment appropriate to their clinical needs, for an adequate period of time, and at the lowest cost to them and their community

3 Why Rational More than 50% of all medicines worldwide are prescribed, dispensed, or sold inappropriately and 50% of patients fail to take them correctly Conversely, about one-third of the world s population lacks access to essential medicines. the proportion of national health budgets spent on medicines ranges between 10% and 20% in developed countries and between 20% and 40% in developing countries.

4 Rational reasons for irrational uses 1. Lack of knowledge, 2. Skills or independent information, 3. Unrestricted availability of medicines, 4. Overwork of health personnel, 5. Inappropriate promotion of medicines and 6. Profit motives from selling medicines.

5 Reasons for Self Medication Poor access to desirable health care Poor regulation prescription drugs and pharmacy practices Overzealous advertisements of medications, Poorly informed public on matters of health and self-care; High burden of diseases, with overlapping symptoms, Poverty which puts consultations out of reach for people

6 Strategi 1. the types of irrational use of medicines, so that strategies can be targeted to wards changing specific problems; 2. the amount of irrational use, so that the size of the problem is known and the impact of the strategies can be monitored; 3. the reasons why medicines are used irrationally, so that appropriate, effective and feasible strategies can be chosen

7 Proporsi RT yang Menyimpan Obat dan Jenis Obat yang Disimpan, Riskesdas Menyimpan Obat Tidak Menyimpan Obat

8 Proporsi RT yang Menyimpan Obat Keras Tanpa Resep* ), Riskesdas 2013 *)Termasuk obat keras dari puskesmas & RS tertentu yg diberikan langsung tanpa menggunakan resep

9 Proporsi RT berdasarkan Jenis Obat yg Disimpan menurut Tempat Tinggal, Riskesdas ,6 79,2 82, ,5 35,9 35,7 30,1 26,4 27,8 17,2 13,2 15,7 6,8 6,8 6,4 Perkotaan Perdesaan Indonesia Obat Keras Obat Bebas Antibiotika Obat Tradisional Obat Tidak Teridentifikasi

10 Goro NTT NTB Sulsel Maluku Sulut Sulbar Sulteng Sultra Jabar Banten Sumbar Papua Jatim Sumsel Pabar Aceh Malut Indon Babel Sumut Jateng Bali Kaltim Kep.R Jambi DKI Riau Beng DIY Kalbar Kalsel Lamp Kalteng ,7 Proporsi RT yang Menyimpan Antibiotika Tanpa Resep* ), Riskesdas ,1 93, *)Termasuk antibiotika dari puskesmas & RS tertentu yg diberikan langsung tanpa menggunakan resep

11 100.0 Proporsi RT berdasarkan Sumber Obat menurut Tempat Tinggal, Riskesdas ,2 35,3 40,5 41,1 37,2 31,5 25,5 23,4 16,9 18,7 16,6 16,8 4,2 4,9 4,3 Perkotaan Perdesaan Indonesia Apotek Toko obat/ warung Yankes formal Nakes Lainnya

12 100.0 Proporsi RT berdasarkan Sumber Obat menurut Kuintil Indeks Kepemilikan, Riskesdas ,5 43,1 45,5 41,3 39,1 35,7 37,0 30,5 32,3 28,7 25,0 24,4 19,7 22,3 15,4 17,3 18,3 19,2 16,8 14,7 5,8 4,5 4,8 3,8 4,3 Terbawah Menengah bawah Menengah Menengah atas Teratas Apotek Toko obat/ warung Yankes formal Nakes Lainnya

13 Proporsi RT berdasarkan Status Obat menurut Tempat Tinggal, Riskesdas ,1 46,7 46,3 48,1 47,0 42,2 33,8 34,4 32, Perkotaan Perdesaan Indonesia Sedang digunakan Untuk persediaan Obat sisa

14 Pengetahuan masyarakat ttg Obat Parameter Pengetahuan: Ciri ciri obat bermutu, aturan minum obat antibiotik, dan logo obat. Sikap responden: pertimbangan responden dalam memilih obat, dan pemberian obat anak Perilaku; sumber informasi tentang obat, dan membaca label obat sebelum membeli obat serta informasi yang dibaca. Hasil PSP masyarakat dalam memilih obat yang aman dan bermutu berkisar mendekati 50%. indeks nilai 4,65 (skala 1-10) Saran: KIE dari pemerintah, /BPOM /Kemenkes kepada masyarakat masih perlu banyak ditingkatkan Selma Siahaan et. all: Know ledge, Attitude, and Practice of Communities on Selecting Safe Medicines in Three Provincies in Indonesia, Jurnal Kefarmasian Indonesia Vol.7 No.2 - Agustus 2017:

15 Affirmative actions

16 BPJS era: game change Cons Referral system Roles change Gov BPJS Ina CBG Prov

17 Reduce reasons for irrational uses 1. Lack of knowledge, 2. Skills or independent information, 3. Unrestricted availability of medicines, 4. Overwork of health personnel, 5. Inappropriate promotion of medicines and 6. Profit motives from selling medicines. KIE REGULATION REGULATION REGULATION Psl 16/18 UU 23/2014

18 Reduce Reasons for Self Medication Poor access Poor regulation prescription drugs Overzealous advertisements of medications, Poorly public information High burden of diseases, Poverty UHC Regulation Regulation KIE Gov Payment

19 KIE stake holders Universities/ heath institute Consumer organizations Mass Media