Assessing Quality of Self-Medication Services in Pharmacies in Bandung, West Java, Indonesia using a Mystery Customer Approach
Keywords:
self-medication, mystery customer, patient assessment, drug selection, drug information
Abstract
Self-medication practice is currently increasing in global population. Apart from the benefits, it is undeniable that self-medication can also have several negative impacts. The outcome of self-medication is affected by pharmacist’s clinical ability to provide self-medication services to the patient. This study was aimed to assess the quality of self-medication services in Indonesia using mystery customer approach. A pilot project had been conducted in Bandung, West Java, Indonesia. Mystery customers act as patients who come to the pharmacy seeking self-medication medications for cough/common cold, diarrhea/constipation, pain/fever, and gastritis cases. A total 232 pharmacies were involved in this study and selected through stratified random sampling. The quality of self-medication services was measured by four subdomains: patient assessment, the accuracy of drug selection, the drug information provided to mystery customer, and lifestyle modification counselling. Result showed that patient assessment regarding signs and symptoms only performed by 42,82% pharmacies in Bandung, 14,44% assessed pharmacological and nonpharmacological therapy prior to visit, and only 10,56% assessed patients’ specific medical condition. Although the percentage of patient assessment performed by pharmacies in Bandung were low, interestingly the accuracy of drug selection is relatively high (85,34%). The most prevalent information provided to patient was instruction to consume the medication (59,09%), meanwhile the least delivered information was about side effect (5,17%). Information about lifestyle modification only delivered by 10,34% pharmacies. The quality of self-medication services in Bandung varies depending on the type of pharmacy and service provider. State-owned pharmacy has a higher overall score of self-medication service than private retail pharmacy and private standalone pharmacy (p<0,05). Based on the service provider, pharmacist have a higher score of self-medication service compared to pharmacy technicians and other personnel in pharmacies (p<0,05). This study emphasizes the importance of the pharmacist’s role in self-medication services to ensure rational and safe treatment for patients.
References
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Onsori, P., Esmaeli, F., Abachi, S., Miremami, M. M., Farahani, A. M., Nouroozi, P., Kazemi, A., Varpaei, H. A., Onsori, P., Esmaeili, F., Abachi, S., Miremami, M. M., Yavari, M., Esmaeili, H., Farahani, A. M., Nouroozi, P., & Kazemi, A. (2020). Self-medication practice, its causes and risk factors among people in Tehran, Iran: a descriptive-analytic study. J Commun Med, 3(1), 1025.
Panda, A., Pradhan, S., Mohapatra, G., & Mohapatra, J. (2016). Drug-related problems associated with self-medication and medication guided by prescription: A pharmacy-based survey. Indian J Pharmacol., 48(5), 515–521.
Parmar, Z., Malhotra, S., & Patel, V. (2015). Prevalence and pattern of self-medication in elderly individuals. International Journal of Basic and Clinical Pharmacology, 4(6), 1095–1099. https://doi.org/10.18203/2319-2003.ijbcp20151338
Richardson, S. J., Brooks, H. L., Bramley, G., & Coleman, J. J. (2014). Evaluating the effectiveness of Self-Administration of Medication (SAM) schemes in the hospital setting: A systematic review of the literature. PLoS ONE, 9(12), 1–18. https://doi.org/10.1371/journal.pone.0113912
Ruiz, M. (2010). Risks of Self-Medication Practices. Current Drug Safety, 5(4), 315–323. https://doi.org/10.2174/157488610792245966
Rutter, P. (2015). Role of community pharmacists in patients. Integrated Pharmacy Research and Practice, 57. http://www.dovepress.com/role-of-community-pharmacists-in-patients39-self-care-and-self-medicat-peer-reviewed-article-IPRP
Selvaraj, K., Ganesh, K. S., & Ramalingam, A. (2014). Prevalence of self-medication practices and its associated factors in Urban Puducherry, India. Perspectives in Clinical Research, 5(1), 32. https://doi.org/10.4103/2229-3485.124569
Sethi, G. R., & Singhal, K. K. (2008). Pulmonary Disease and Corticosteroids. Indian Journal of Pediatrics, 75(10), 1045–1056.
Shon, N., Yarbrough, T., & Shah, A. (2021). Aluminum Hydroxide. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546669/
Sinulingga, B. O. (2020). Self-Medication Behavior. Journal of Noursing and Midwifery, 2(2), 238–241.
Suleiman, A. (2013). Self-medication and the advisory role of pharmacists in Riyadh, Saudi Arabia. Archives of Pharmacy Practice, 4(4), 180. https://doi.org/10.4103/2045-080x.123228
Vacher, R., Lagarce, L., Ghamrawi, S., Laugier-Castellan, D., Vial, T., Bagheri, H., Babin, M., & Briet, M. (2020). Drug interactions related to self-medication: a French pharmacovigilance database study. Fundamental and Clinical Pharmacology, 34(5), 623–631. https://doi.org/10.1111/fcp.12546
Veiga, P., Cavaco, A. M., Lapão, L. V., & Guerreiro, M. P. (2021). Self-medication consultations in community pharmacy: An exploratory study on teams’ performance, client-reported outcomes and satisfaction. In Pharmacy Practice (Vol. 19, Issue 1, pp. 1–8). https://doi.org/10.18549/PharmPract.2021.1.2138
Wingate, D., Phillips, S. F., Lewis, S. J., Malagelada, J. R., Speelman, P., Steffen, R., & Tytgat, G. N. J. (2001). Guidelines for adults on self-medication for the treatment of acute diarrhoea. Alimentary Pharmacology and Therapeutics, 15(6), 773–782. https://doi.org/10.1046/j.1365-2036.2001.00993.x
Wöhrl, S. (2018). NSAID hypersensitivity – recommendations for diagnostic work up and patient management. Allergo Journal International, 27(4), 114–121. https://doi.org/10.1007/s40629-018-0064-0
Wongrakpanich, S., Wongrakpanich, A., Melhado, K., & Rangaswami, J. (2018). A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging and Disease, 9(1), 143–150. https://doi.org/10.14336/AD.2017.0306
Zeid, W., Hamed, M., Mansour, N., & Diab, R. (2020). Prevalence and associated risk factors of self-medication among patients attending El-Mahsama family practice center, Ismailia, Egypt. Bulletin of the National Research Centre, 44(1). https://doi.org/10.1186/s42269-020-00351-7
Asseray, N., Ballereau, F., Trombert-Paviot, B., Bouget, J., Foucher, N., Renaud, B., Roulet, L., Kierzek, G., Armand-Perroux, A., Potel, G., Schmidt, J., Carpentier, F., & Queneau, P. (2013). Frequency and severity of adverse drug reactions due to self-medication: A cross-sectional multicentre survey in emergency departments. Drug Safety, 36(12), 1159–1168. https://doi.org/10.1007/s40264-013-0114-y
Barros, G. A. M. de, Calonego, M. A. M., Mendes, R. F., Castro, R. A. M., Faria, J. F. G., Trivellato, S. A., Cavalcante, R. S., Fukushima, F. B., & Dias, A. (2019). The use of analgesics and risk of self-medication in an urban population sample: cross-sectional study. Brazilian Journal of Anesthesiology (English Edition), 69(6), 529–536. https://doi.org/10.1016/j.bjane.2019.10.006
Brata, C., Fisher, C., Marjadi, B., Schneider, C. R., & Clifford, R. M. (2016). Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: A qualitative study. BMC Health Services Research, 16(1), 1–10. https://doi.org/10.1186/s12913-016-1425-3
Brata, C., Marjadi, B., Schneider, C. R., Murray, K., & Clifford, R. M. (2015). Information-gathering for self-medication via Eastern Indonesian community pharmacies: A cross-sectional study. BMC Health Services Research, 15(1), 1–11. https://doi.org/10.1186/s12913-014-0670-6
Candradewi, S. F., & Kristina, S. A. (2017). Self Medication Practice and Consumers Opinion about Non-prescription Drugs in Bantul. Pharmaciana, 7(1), 41. https://doi.org/10.12928/pharmaciana.v7i1.5193
Durrieu, G., Maupiler, M., Rousseau, V., Chebane, L., Montastruc, F., Bondon-Guitton, E., & Montastruc, J. L. (2017). Frequency and Nature of Adverse Drug Reactions Due to Non-Prescription Drugs in Children: A Retrospective Analysis from the French Pharmacovigilance Database. Pediatric Drugs, 20(1), 81–87. https://doi.org/10.1007/s40272-017-0255-z
Erebara, A., Bozzo, P., Einarson, A., & Koren, G. (2008). Treating the common cold during pregnancy. Canadian Family Physician, 54(5), 687–689.
Food and Drug Administration. (2019). FDA limits packaging for anti-diarrhea medicine loperamide (Imodium) to encourage safe use. Available online at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-limits-packaging-anti-diarrhea-medicine-loperamide-imodium-encourage-safe-use
Głowacka, K., & Wiela-Hojeńska, A. (2021). Pseudoephedrine—benefits and risks. International Journal of Molecular Sciences, 22(10). https://doi.org/10.3390/ijms22105146
Indonesian Central Statistic Agency. (2022). Percentage of Self-Medication Practice in Indonesia.
Itsnayain, A. S., Satibi, S., & Fudholi, A. (2021). Patient Satisfaction of Pharmaceutical Services in Primary Healthcare Facilities based on Pharmacist Practice in Mataram. Majalah Farmaseutik, 17(2), 192–197. https://doi.org/10.22146/farmaseutik.v17i2.53832
Kifle, Z. D., Mekuria, A. B., Anteneh, D. A., & Enyew, E. F. (2021). Self-medication Practice and Associated Factors among Private Health Sciences Students in Gondar Town, North West Ethiopia. A Cross-sectional Study. Inquiry (United States), 58. https://doi.org/10.1177/00469580211005188
Kumari, K., Toppo, M. S., & Priyanki, P. (2019). Self medication practices of over the counter analgesic drugs among medical students in a tertiary care hospital in Jharkhand, India. International Journal of Basic & Clinical Pharmacology, 8(5), 903. https://doi.org/10.18203/2319-2003.ijbcp20191573
Makeen, H., Albarraq, A., Banji, O. ., Taymour, S., Meraya, A., Alqhatani, S., & Banji, D. (2019). Knowledge, attitudes, and practices toward self-medication in a rural population in South-Western Saudi Arabia. Saudi Journal for Health Sciences, 8(1), 54. https://doi.org/10.4103/sjhs.sjhs_9_19
Mehuys, E., Van Bortel, L., De Bolle, L., Van Tongelen, I., Remon, J. P., & De Looze, D. (2009). Self-medication of upper gastrointestinal symptoms: A community pharmacy study. Annals of Pharmacotherapy, 43(5), 890–898. https://doi.org/10.1345/aph.1L647
Noone, J., & Blanchette, C. M. (2018). The value of self-medication: summary of existing evidence. Journal of Medical Economics, 21(2), 201–211. https://doi.org/10.1080/13696998.2017.1390473
Onsori, P., Esmaeli, F., Abachi, S., Miremami, M. M., Farahani, A. M., Nouroozi, P., Kazemi, A., Varpaei, H. A., Onsori, P., Esmaeili, F., Abachi, S., Miremami, M. M., Yavari, M., Esmaeili, H., Farahani, A. M., Nouroozi, P., & Kazemi, A. (2020). Self-medication practice, its causes and risk factors among people in Tehran, Iran: a descriptive-analytic study. J Commun Med, 3(1), 1025.
Panda, A., Pradhan, S., Mohapatra, G., & Mohapatra, J. (2016). Drug-related problems associated with self-medication and medication guided by prescription: A pharmacy-based survey. Indian J Pharmacol., 48(5), 515–521.
Parmar, Z., Malhotra, S., & Patel, V. (2015). Prevalence and pattern of self-medication in elderly individuals. International Journal of Basic and Clinical Pharmacology, 4(6), 1095–1099. https://doi.org/10.18203/2319-2003.ijbcp20151338
Richardson, S. J., Brooks, H. L., Bramley, G., & Coleman, J. J. (2014). Evaluating the effectiveness of Self-Administration of Medication (SAM) schemes in the hospital setting: A systematic review of the literature. PLoS ONE, 9(12), 1–18. https://doi.org/10.1371/journal.pone.0113912
Ruiz, M. (2010). Risks of Self-Medication Practices. Current Drug Safety, 5(4), 315–323. https://doi.org/10.2174/157488610792245966
Rutter, P. (2015). Role of community pharmacists in patients. Integrated Pharmacy Research and Practice, 57. http://www.dovepress.com/role-of-community-pharmacists-in-patients39-self-care-and-self-medicat-peer-reviewed-article-IPRP
Selvaraj, K., Ganesh, K. S., & Ramalingam, A. (2014). Prevalence of self-medication practices and its associated factors in Urban Puducherry, India. Perspectives in Clinical Research, 5(1), 32. https://doi.org/10.4103/2229-3485.124569
Sethi, G. R., & Singhal, K. K. (2008). Pulmonary Disease and Corticosteroids. Indian Journal of Pediatrics, 75(10), 1045–1056.
Shon, N., Yarbrough, T., & Shah, A. (2021). Aluminum Hydroxide. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546669/
Sinulingga, B. O. (2020). Self-Medication Behavior. Journal of Noursing and Midwifery, 2(2), 238–241.
Suleiman, A. (2013). Self-medication and the advisory role of pharmacists in Riyadh, Saudi Arabia. Archives of Pharmacy Practice, 4(4), 180. https://doi.org/10.4103/2045-080x.123228
Vacher, R., Lagarce, L., Ghamrawi, S., Laugier-Castellan, D., Vial, T., Bagheri, H., Babin, M., & Briet, M. (2020). Drug interactions related to self-medication: a French pharmacovigilance database study. Fundamental and Clinical Pharmacology, 34(5), 623–631. https://doi.org/10.1111/fcp.12546
Veiga, P., Cavaco, A. M., Lapão, L. V., & Guerreiro, M. P. (2021). Self-medication consultations in community pharmacy: An exploratory study on teams’ performance, client-reported outcomes and satisfaction. In Pharmacy Practice (Vol. 19, Issue 1, pp. 1–8). https://doi.org/10.18549/PharmPract.2021.1.2138
Wingate, D., Phillips, S. F., Lewis, S. J., Malagelada, J. R., Speelman, P., Steffen, R., & Tytgat, G. N. J. (2001). Guidelines for adults on self-medication for the treatment of acute diarrhoea. Alimentary Pharmacology and Therapeutics, 15(6), 773–782. https://doi.org/10.1046/j.1365-2036.2001.00993.x
Wöhrl, S. (2018). NSAID hypersensitivity – recommendations for diagnostic work up and patient management. Allergo Journal International, 27(4), 114–121. https://doi.org/10.1007/s40629-018-0064-0
Wongrakpanich, S., Wongrakpanich, A., Melhado, K., & Rangaswami, J. (2018). A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging and Disease, 9(1), 143–150. https://doi.org/10.14336/AD.2017.0306
Zeid, W., Hamed, M., Mansour, N., & Diab, R. (2020). Prevalence and associated risk factors of self-medication among patients attending El-Mahsama family practice center, Ismailia, Egypt. Bulletin of the National Research Centre, 44(1). https://doi.org/10.1186/s42269-020-00351-7
Published
2023-03-27
How to Cite
Roseno, M., & Widyastiwi, W. (2023). Assessing Quality of Self-Medication Services in Pharmacies in Bandung, West Java, Indonesia using a Mystery Customer Approach. Indonesian Journal of Pharmacy, 34(2), 312–323. https://doi.org/10.22146/ijp.4145
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Research Article
