Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter February 7, 2020

Evaluation of rational drug use based on World Health Organization prescribing indicators in a primary care center in Pamekasan East Java, Indonesia

  • Eko Prasetio ORCID logo , Wahyu Utami , Zulhabri Othman , Ari Wardani , Abdul Rahem and Andi Hermansyah ORCID logo EMAIL logo



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.


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.


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.


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.


The authors thank the Pamekasan District Health Office and East Java Province Health Office for supporting data related rational drug use.

  1. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  2. Research funding: None declared.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors' institutional review board or equivalent committee. (070/8324/209.4/2019). This study has obtained permission from the Government of East Java Province and District Health Office Pamekasan, Indonesia.


[1] Mekonnen S, Getnet M, Bereket M, Firehiwot A, Tesfaye G. Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study. BMC Health Serv Res 2017;17:161.10.1186/s12913-017-2097-3Search in Google Scholar PubMed PubMed Central

[2] Aqeel A, Sobia K, Maria M, Sidra M, Babar M. Evaluation of Rational Drug Use at Teaching Hospitals in Punjab, Pakistan. J Pharm Pract Commun Med 2016;2:54–7.10.5530/jppcm.2016.2.6Search in Google Scholar

[3] Cindra TY, Kusnandar A, Alfi NI. Evaluation of rational drug use for acute pharyngitis associated with the incidence and prevalence of the disease at two community health centers in Indonesia. Sci Pharm 2017;85:2–9.Search in Google Scholar

[4] World Health Organization. Promoting rational use of medicine: core component. WHO policy perspective on medicine. Geneva: World Health Organization, 2002.Search in Google Scholar

[5] Ministry of Health of the Republic of Indonesia. Module for the use of rational drugs. Jakarta: Ministry of Health of the Republic of Indonesia, 2015.Search in Google Scholar

[6] Ministry of Health of the Republic of Indonesia. Mobilization module using rational medication. Jakarta: Ministry of Health of the Republic of Indonesia, 2012.Search in Google Scholar

[7] Kardela W, Andrajati R, Supardi S. Comparison of rational drug use based on WHO indicators in district health centers between Depok City and South Jakarta. J Kefarmasian Indonesia 2014;4:91–102.Search in Google Scholar

[8] Ministry of Health of the Republic of Indonesia. Decree of the minister of health of the Republic of Indonesia number 128/MENKES/SK/II/2004 about the basic policy of the public health center. Jakarta: Ministry of Health of the Republic of Indonesia, 2004.Search in Google Scholar

[9] Pamekasan Health Office. Pamekasan regency health profile 2018. Pamekasan Health Office, 2019.Search in Google Scholar

[10] Destiani D, Naja S, Nurhadiyah A, et al. Outpatient prescribing patterns: observational studies using WHO prescribing criteria in one of the Bandung health facilities. J Farmasi Klinik Indonesia 2016;5:225–31.Search in Google Scholar

[11] Sukandar EY, Andrajati R, Sigit JI, Adnyana IK, Setiadji AA, Kusnandar. Iso Farmakoterapi. Jakarta: PT. ISFI, 2008.Search in Google Scholar

[12] Senok AC, Ismaeel AY, Al-Qashar FA, Agab WA. Pattern of upper respiratory tract infections and physicians’ antibiotic prescribing practices in Bahrain. Med Princ Pract 2009;18:170–4.10.1159/000204345Search in Google Scholar PubMed

[13] Pathak D, Pathak A, Marrone G, Diwan V, Lundborg CS. Adherence to treatment guidelines for acute diarrhoea in children up to 12 years in Ujjain, India – a cross sectional prescription analysis. BMC Infect Dis 2011;11:32.10.1186/1471-2334-11-32Search in Google Scholar PubMed PubMed Central

[14] Sadikin ZD. Rational drug use. J Indon Med Assoc. 2011;61:4.Search in Google Scholar

[15] Hermansyah A, Sukorini AI, Setiawan CD, Priyandani Y. The conflicts between professional and non professional work of community pharmacists in Indonesia. Pharm Pract (Internet). 2012;10:33–9.10.4321/S1886-36552012000100006Search in Google Scholar PubMed PubMed Central

[16] Hermansyah A, Sainsbury E, Krass I. Multiple policy approches in improving community pharmacy practice: the case in Indonesia. BMC Health Serv Res 2018;18:449.10.1186/s12913-018-3258-8Search in Google Scholar PubMed PubMed Central

Received: 2019-10-31
Accepted: 2019-11-15
Published Online: 2020-02-07

© 2019 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 10.6.2023 from
Scroll to top button