EVALUASI IMPLEMENTASI KEBIJAKAN STANDAR PELAYANAN KEFARMASIAN DI PUSKESMAS WILAYAH PERIFER KOTA SAMARINDA

Objective-The federal government boosted support for community health centers in medically underserved areas in 2002-2007.This investigation compared trends in behavioral health services provided by community health centers nationwide during the first several years of that initiative with immediately prior trends.Methods-Data were extracted from the Health Resources and Services Administration's Uniform Data System on community health centers for 1998-2007 (2007, N=1,067).Regression analyses revealed trends in individual community health centers' likelihood of providing on-site specialty mental health care, crisis services, and substance abuse treatment.Aggregate data were used to show national trends in numbers of behavioral health encounters, patients, and encounters per patient.Results-The number of federally funded community health centers increased 43% between 2001 and 2007, from 748 to 1,067, over twice the annual growth rate between 1998 and 2001.However, trends in individual community health centers' likelihood of providing different types of behavioral health care were generally consistent across the two time periods.In 2007, 77% of community health centers offered specialty mental health services, 20% offered 24-hour crisis intervention services, and 51% offered substance abuse treatment.The mean number of mental health encounters per mental health patient at community health centers in 2007 was 2.9.Conclusions-The behavioral health care safety net has widened through rapid recent growth in the number of community health centers as well as a continuing increase in the proportion offering specialty mental health services.Access to behavioral health care remains a major public health concern in the United States (1-4), most acutely affecting people who have low income or are uninsured (5-7).One

Background: The implementation of clinical pharmacy services is critical in Indonesia's community health centres (CHCs). However, there is a paucity of studies evaluating the implementation of such services. This study aimed to evaluate clinical pharmacy services by CHCs in West Java, Indonesia. Methods: This cross-sectional study used a self-completed questionnaire, including several indicators of the standard pharmacy services, to evaluate the implementation of clinical pharmacy services by CHCs in West Java, Indonesia. Results: In total, 39 CHCs participated in this study. The home visits, drug therapy and adverse monitoring, counselling services, and drug use evaluation were not well performed as determined. In contrast, drug information services, rational use of medicine, and prescription have been well performed. There was no app or IoT (internet of things) system to support the clinical pharmacy services in Indonesia’s CHCs. Conclusions: The performance of the clinical pharmacy services of accredited CHCs should be improved to support Community Health Centers in Indonesia.

Background The Government of Indonesia has put in place many interventions for rationalizing drug use at all levels of the health services including in primary care centers (puskesmas). One of the programs for the rational use of drugs at the puskesmas is the monitoring and evaluation of drug use conducted by pharmacists. The purpose of this research was to evaluate the rationality of drug use in Pamekasan puskesmas that use World Health Organization (WHO) prescribing indicators and to find the difference in the percentage of rationality of drug use between puskesmas in Pamekasan. Methods This study reviewed official documents considering reporting of rational drug use. The documents were obtained from the district health office or from the public domain from 2014 to 2018. Data were then collated, extracted, and presented as frequencies. Results The percentage prescribed for antibiotics for acute respiratory infection (ARI) non-pneumonia was 47.27% and percentage prescribing antibiotic drugs in a non-specific diarrhea was 59.85%. The percentage prescribed for injection was 36.15%. The average number of drugs prescribed per treatment was 2.61. Conclusions The majority of WHO guidelines stated that prescribing indicators were not met by the puskesmas in Pamekasan, except for the parameters for the average number of drugs prescribed per consultation. This shows an alarming clarion call for the local healthcare stakeholders to improve such situations.

Aims: The Implementation of Clinical Pharmacy Services (CPS) in hospitals is currently gaining attention in an effort to rationalize drug use in many developing countries. This study aims to introduce and evaluate ward-based CPS in a Respiratory Diseases clinic in North Cyprus and assess its efficacy and physician's perceptions toward the services.
 Study Design: A prospective interventional study.
 Place and Duration of Study: The study was carried out in the respiratory clinic from 01 December 2013, to 30 January 2014 at Near East University Hospital, in Nicosia, North Cyprus.
 Methodology: Clinical Pharmacy Services (CPS) were introduced and documented over the study period of 60 days in a tertiary university hospital. DTPs and Interventions were documented and classified using DTP classification tool obtained from previous studies, and later evaluated by an independent clinical committee for their feasibility. Physician’s attitudes and perceptions were evaluated before for and after introducing CPS's using a questionnaire tool.
 Results: 82.35% of the targeted physician's sample have responded to baseline survey, (n=17) majority (92%) did not have any previous interaction with clinical pharmacists, they generally well perceived and had high expectations to pharmaceutical care services in general. This further enhanced the post-implementation of CPS. 118 interventions were carried during the program, 86.6% accepted and regarded as clinically relevant. Interventions mostly related to cardiovascular agents. Add/ change/stop medications were the most common type of interventions (21%). Most common resultant outcome was to avoid adverse effects or toxicities. The intervention was significantly related to the number of drugs used (r=0,487; p=0,006), the rate of acceptance significantly was higher to services compared to DRP interventions (p<0.005).
 Conclusion: The introduction of CPS's lead to clinically relevant and highly accepted optimization of medicine use in different wards and clinics including respiratory diseases clinic in the case of this study, it was relatively well perceived by physicians, but also could be more valued if more optimized and practiced by talented proactive clinical pharmacists within a multidisciplinary team.

Rational drug use (RDU) is an indicator to evaluates a treatment given to patients, like proper medication, precise diagnosis, precise dosing. Community Health Center (CHC) has the risk of irrational drug use. In this study, researchers selected N and BL CHC, aiming to evaluate the prescribing indicators based on three diseases which are non-pneumonia acute respiratory infection (ARI), non-specific diarrhea and myalgia, and the facility indicators with DOEN (list of essential national medicines) availability and 20 mandatory drugs. This research was a descriptive-analytical study with cross-sectional methods where the data retrieval of the prescribing is taken from January to December 2018. The study used the normality test and homogeneity test before independent sample T-test, from the third outcome of the test, the N and BL CHC could be said to differ significantly of RDU. It can be concluded that rational drug use is reviewed from a prescribing indicator based on disease and facility indicator. The results of RDU are rational in N CHC, in contrast with BL CHC which is not rational with the results of the RDU in N CHC is 101.44% and BL CHC is 89.81%. The results of N CHC is better than BL CHC, which both CHCs have fulfilled the target of the government, for 68% in 2018. In both CHCs for the facility indicator, there are a DOEN and 20 essential medicines.

Background: Rational drug selection is the key to quality health services. Improper use of antibiotics is one of the irrational uses of drugs and causes various health problems such as bacterial resistance and economic and social impacts. This study aimed to determine the pattern of antibiotic use against indicators of rational drug use in Sambi Rejo Public Health Center, Langkat Regency. Methods: The research method was carried out descriptively by retrospective data collection. Data on the use of antibiotics for the indicator of rational drug use is obtainable from the Rational Drug Use report data for the period January - December 2020, while data on pharmaceutical services was obtained in January - February 2021. The results of the study: The results showed that the use of antibiotics for indicators of rational drug use was Respiratory Tract Infection. The number of non-pneumonia was 28.33%, non-specific diarrhea was 46, 17 and the mean of drug items per prescription was 3.75 drug items. The results of research with in-depth interviews, participant observation and documentation study show that pharmaceutical services at the Sambi Rejo Health Center have been running quite well. The study concluded that pharmaceutical services at the Sambi Rejo Health Center have been running quite well, while the implementation of the rational drug use program at the Sambi Rejo Health Center has not been going well with the high use of antibiotics against indicators of rational drug use set by WHO.

Clinical pharmacy services in pharmacies are an important aspect to ensure the quality, safety, and effectiveness of drug use. This study aims to analyze the implementation of the Minister of Health Regulation (PMK) Number 73 of 2016 concerning Pharmaceutical Service Standards in pharmacies in the Kapanewon Minggir area, Sleman, Yogyakarta. The method used is descriptive analytics with a mixed method approach through document observation, implementation observation, and in-depth interviews. The results showed that the aspects of prescribing (86–91%) and dispensing (86–93%) had been carried out well, while drug information services (28.5%) and counseling (50–100%) had not been carried out comprehensively and consistently between pharmacies. Meanwhile, home pharmacy care services, drug therapy monitoring, and drug side effect monitoring have not been implemented at all (0%). The main obstacles identified include the limited number of pharmacists, high workload, lack of documentation, and lack of awareness and support of the system. The conclusion of this study emphasizes that the implementation of clinical pharmacy services at the Kapanewon Minggir pharmacy is not optimal and is still far from the PMK 73/2016 standard, so it is necessary to strengthen the capacity of pharmacists, add manpower, and support systems so that the quality of clinical pharmacy services can be improved.

ABSTRACTRationaleThe implementation of Clinical Pharmacy Services in healthcare systems is multifactorial and complex. Some studies summarize the implementation research of these services in both outpatient and inpatient contexts. However, the literature lacks a comprehensive synthesis to understand how the implementation process occurs in Primary Health Care.AimTo map, at an international level, the studies on the implementation of Clinical Pharmacy Services in Primary Health Care.MethodThis scoping review followed the recommendations of the JBI Manual for Evidence Synthesis for Scoping Reviews. A systematic search was conducted in May 2023 across six electronic databases, grey literature, and the references of the selected studies. Original studies that described the implementation process of Clinical Pharmacy Services in Primary Health Care were eligible for inclusion. Two researchers independently assessed the studies based on eligibility criteria and extracted data from the selected articles. Data were presented descriptively.ResultsA total of 97 studies were included, with 85.6% (n = 83) conducted in developed countries. A significant emphasis was observed on qualitative and mixed‐methods research, accounting for 46.4% (n = 45) of the studies. Only 22.7% (n = 22) of the studies utilized theoretical models as research guides, while 96.9% (n = 94), did not report on the implementation phase. Comprehensive Medication Management (36.8%, n = 35) was the most cited type of service. The most assessed implementation outcome was feasibility, at 73.2% (n = 71). A total of 47.4% (n = 46) assessed outcomes related to the implemented service, which included clinical, economic, and/or humanistic aspects.ConclusionThis study revealed numerous publications on the implementation of clinical services provided by pharmacists in primary care. These findings can guide future research on the implementation of these services and highlight the need for developing and underdeveloped countries to explore this topic further.

Pharmacists provide pharmaceutical care service in order to support rational drug use.However, still lack of evidence to show its outcomes.Therefore, this cross-sectional descriptive study and qualitative study were conducted to evaluate the outcomes of pharmaceutical care services and to clarify pharmaceutical care services format for promoting rational drug use in chronic patients.Outcomes of pharmaceutical care service in Lampang Hospital both in outpatients and inpatients in fiscal year 2015 were collected.Doctors, nurses and pharmacists anticipated in pharmaceutical care services were in depth interviewed regarding the satisfaction of pharmaceutical service, the suitable and benefit for staff and patient, suggestion for pharmaceutical services and policy suggestion.Data were analyzed using descriptive statistics.The results revealed that pharmacist who provided pharmaceutical care services promoted effective use of drug use by audit and feedback inappropriate prescriptions, promoted safety use of drug by preventing adverse drug events and drug-drug interaction, increased patient compliance use of drug and reduced drug cost from medication reconciliation process.Data from indepth interviewing found that pharmacists who provide pharmaceutical care services, doctors and nurses who are co-worker were satisfy with currently providing pharmaceutical care services and had consensus that the pharmacy services were more effective and rational use support.Patients got correct drug, had more safety in drug use, could use drug correctly and appropriately and save cost.This research confirmed that we should have pharmaceutical care services or clinical pharmacists in chronic patient care services as tools to promote rational drug use in heath care setting.

AimThis systematic review (SR) was undertaken to identify and summarise any factors which influence the implementation of paediatric clinical pharmacy service (CPS) from service users’ perspectives in hospital settings.MethodLiterature search...

One of the objectives of pharmaceutical standards is to improve the quality of pharmaceutical services in community health centers and provide satisfactory services to patients. The objective of this study was to determine the level of patient satisfaction with pharmaceutical services at the pharmacy department of the Paal Lima community health center in Jambi City using the CSI method. This was a quantitative study with a descriptive, prospective design, involving the administration of questionnaires to patients who collected medication from the pharmacy department of the Paal Lima community health center. The results of the study showed patient satisfaction based on respondent characteristics: the majority were female (75 respondents, 75%), the majority were aged 26–35 years (37 respondents, 37%), the majority had a high school education (55 respondents, 55%), and the majority were housewives (58 respondents, 58%). Based on reliability dimension 75.6%, based on responsiveness dimension 72.8%, based on assurance dimension 73.8%, based on empathy dimension 82.6%, based on tangibility dimension 69.8%, with an average CSI score of 74.92%. The analysis reveals that patient satisfaction levels with pharmaceutical services at the Paal Lima Public Health Center Pharmacy in Jambi City, using the CSI (Customer Satisfaction Index) method, yielded a score of 74.92%, indicating that overall, patients are satisfied with the services provided.

Puskesmas (Community Health Center) is one of the primary health facilities that is the front line in providing health services to the community. One of the important pillars in improving the quality of health services in the Community Health Center is pharmaceutical services. The intended pharmaceutical services include the provision of drugs, information on drug use, and counseling to patients. Patient satisfaction is an important indicator used in evaluating the quality of health services. This study aims to determine the level of satisfaction felt by patients with pharmaceutical services and evaluate pharmaceutical services at the Air Dingin Community Health Center as a form of improving the quality of health services. This study used a quantitative survey conducted cross-sectionally in September 2024 at the Air Dingin Community Health Center in Padang City with 45 respondents. This study obtained results, namely the level of patient satisfaction in the reliability aspect of 82.78% (very satisfied), the responsive element of 91.81% (very satisfied), the assurance aspect of 98.44% (very satisfied), the empathy aspect of 91.68% (very satisfied), and the tangible aspect of 85.85% (very satisfied). Based on the results of the research that has been conducted, it was concluded that patient satisfaction in all aspects, namely 90.11%, is included in the very satisfied category.

Pharmaceutical services initially focusing solely on drug management (Drug Oriented) to comprehensive services that include clinical pharmacy services and medication services aimed at improving patients' quality of life (Patient Oriented). Clinical pharmacy services in pharmacies are part of pharmaceutical services that are directly responsible to patients in relation to pharmaceutical preparations, medical devices, and disposable medical supplies. This study aims to determine the implementation of clinical pharmacy services in pharmacies in the Gedong Tataan District of Pesawaran Regency. The research approach used was quantitative descriptive with a simple random sampling technique. The sample in this study consisted of 16 pharmacies and pharmacy staff working in pharmacies in the Gedong Tataan District, Pesawaran Regency, who met the inclusion and exclusion criteria. Data collection was carried out by conducting with guided interviews using questionnaires and observation on the implementation of clinical pharmacy services by pharmacy staff. The results showed that the clinical pharmacy services implemented in pharmacies in Gedong Tataan District, Pesawaran Regency, were prescription assessment and services by 74% with a good category (61-80%), dispensing by 95% with a very good category (81-100%), and drug information services (PIO) obtained a percentage of 72% with a good category (61-80%). Clinical pharmacy services were mostly carried out by Pharmacy Vocational Personnel (TVF) at 37.5%. Clinical pharmacy services in pharmacies throughout the Gedong Tataan District of Pesawaran Regency have not been fully implemented in accordance with the standards of pharmaceutical services in pharmacies according to Permenkes No. 73 of 2016, as there are still several aspects that have not been carried out.

Pharmaceutical services are the main support in every health facility and are part of health services that aim to increase the rational, safe and efficient use of drugs in order to achieve an increase in the quality of human life. Efforts to improve pharmacy services in the main clinic need to be accompanied by an evaluation of the level of satisfaction. Consumer satisfaction is a response to every service received and is an important part because patient satisfaction cannot be separated from the quality of health services. The purpose of this study was to determine the characteristics of patients based on gender, age, last education and occupation. Then to determine the level of patient satisfaction with pharmaceutical services. The method used in this research is descriptive method with a quantitative approach. Data analysis uses percentages and a Likert scale. The population in this study were outpatients who received pharmacy services at the main clinical pharmacy installation "X" Semarang City. The results of the characteristic study showed that 80% of the respondents were female. Based on the age of the respondents who visited the most were aged 26 - 35 years (33.1%), and the least were aged 56 - 65 years (7.4%). The majority of respondents have high school education (42.3%). Most of the respondents' occupational data in this study were other (60%), dominated by housewives. The frequency of visits (71.4%) of respondents visited more than 2 times and 28.6% of respondents visited 2 times. The average result of patient satisfaction based on five dimensions obtained a value of 3.04 with a satisfied statement. Keywords: Pharmaceutical services, ServQual, satisfaction, primary clinics

Provision of pharmacy services in community health centers and migrant health centers.