The effect of the implementation of evidence-based drug formulary on antibacterial use in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesia

Abstract

The increase of drug expenditure in the hospital has facilitated the implementation of an evidence-based drug formulary. The aim of this study was to assess the change in antibacterial use after the implementation of an evidence-based drug formulary in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesia. This study used a preposttest design. Drug use data in the period before (2010-2011) and after (2012-2013) the formulary implementation were extracted from the hospital medical records. The drug use in the hospital before and after the implementation was compared using t-test and chi-square test, with the significance level of 0.05. Average number of drugs prescribed per prescription after the implementation was similar with that before the implementation (4.4 vs 4.6; p > 0.05). However, the proportion of generic drugs prescribed increased significantly after the formulary implementation (17.0% vs 52.7%; p < 0.05). Moreover, it was still significantly increased when the analysis was conducted only for antibacterial drugs (25.9% vs 72.0%; p < 0.05). Average drug cost per prescription was 34% lower after the intervention (p < 0.05), and the average cost for antibacterial drug was also decreased (26%). The use of antibacterial drugs was significantly decreased after the intervention (12.5% vs 6.9%; p < 0.05). The most often antibacterial drugs prescribed before the interventions were beta-lactams and macrolides; while quinolones were more increasingly used after the intervention. In conclusion, the implementation of evidencebased hospital drug formulary in a private hospital at Tanjung Enim, Sumatera Selatan significantly increase generic drug use and decreased antibacterial use and average drug cost per prescription. ABSTRAKPeningkatan belanja obat di rumah sakit menyebabkan dibuatnya formularium obat berbasis bukti. Tujuan dari penelitian ini adalah untuk menilai perubahan penggunaan antibakteri setelah implementasi formularium obat berbasis bukti di rumah sakit swasta di Tanjung Enim, Sumatera Selatan, Indonesia. Penelitian ini menggunakan rancangan prepost tes menggunakan data rekam medik rumah sakit dari periode sebelum (2010)(2011) 17 Kristin et al., The effect of the implementation of evidence-based drug formularyon antibacterial use in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesiadan setelah (2012-2013) implementasi formularium. Indikator penggunaan obat sebelum dan sesudah implementasi dibandingkan dengan menggunakan uji t dan chi square, dengan tingkat signifikansi 0,05. Jumlah rata-rata obat yang diresepkan perlembar resep sebelum dan setelah implementasi setara (4,4 vs 4,6; p > 0,05). Namun, proporsi obat generik yang diresepkan meningkat secara nyata setelah penerapan formularium (17,0 vs 52,7%; p <0,05). Selain itu peningkat secara nyata masih dijumpai ketika analisis dilakukan hanya untuk antibakteri (25,9 vs 72,0%; p <0,05). Rata-rata biaya obat per resep adalah 34% lebih rendah setelah implementasi (p <0,05) dan biaya rata-rata untuk antibakteri juga menurun ...

Key Factors for Sustainable Rational Use of Medicine Program in Gunungkidul and Sleman Districts, Indonesia

“…Other studied by Kristin et al [26], using evidence-based hospital medicine formularies, had significantly reduced antibiotics use (12.5% vs. 6.9%; p<0.05) in private hospitals in Tanjung Enim.…”