Evaluasi kepatuhan terhadap formularium 2002 dan penggunaan obat generik di Bangsal Rawat Inap Penyakit Dalam Rumah Sakit Dr. Sardjito
SURYANINGSIH, Cicik, dr. Sulanto Saleh Danu, SpFK
2004 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang : RS Dr. Sardjito diresmikan tahun 1982, kurun waktu sampai dengan tahun 1990 rumah sakit belum memiliki formularium. Pelayanan farmasi belum optimal, obat expired, stock over atau stock out menjadi masalah pengelolaan obat pada periode tersebut. Tahun 1990, rumah sakit telah memiliki formularium, revisi pertama tahun 1998, selanjutnya tahun 2000, dan terakhir formularium di revisi tahun 2002. Disisi lain tahun 2000 Direksi rumah sakit mengeluarkan ketentuan penggunaan Obat Generik berdasar kelas perawatan. Tujuan Penelitian : Mengidentifikasi sejauh mana kepatuhan dokter terhadap formularium 2002 dan penggunaan obat generik berdasar kelas perawatan serta persepsi dokter terhadap formularium dan penggunaan obat generik. Metode Penelitian : Merupakan penelitian diskriptif-analitik. Subjek penelitian dokter stase di bangsal penyakit dalam IRNA I periode Juli 2002 – Juni 2003. Data peresepan obat didapat dari Kartu Instruksi Pemberian Obat (KIPO), meliputi persentase obat sesuai formularium 2002, persentase obat generik, persentase obat nama dagang, persentase antibiotika. Data persepsi menggunakan kuesioner tertutup dengan skala Likert, dan data kepatuhan menggunakan kuesioner terbuka. Hasil : Hasil penelitian ini menunjukkan rata-rata obat sesuai formularium 85,19%, terdiri atas obat generik 34,53%, dan obat nama dagang 50,66%, untuk obat antibiotika 15,03% dan persentase obat generik rawat inap 44,27%. Sedang persentase peresepan obat generik kelas I 38,44%, kelas II 41,53% dan kelas III 43,87%. Kelompok dokter persepsi sedang terhadap formularium lebih besar dari kelompok persepsi tinggi. Demikian pula kelompok dokter persepsi sedang terhadap penggunaan obat generik lebih besar dari kelompok dokter persepsi tinggi terhadap penggunaan obat generik. Kesimpulan : Kepatuhan terhadap formularium belum optimal dan penggunaan obat generik berdasar kelas perawatan tidak sesuai ketentuan yang berlaku. Kepatuhan terhadap formularium rumah sakit disebabkan, ketersediaan obat formularium dirumah sakit, daftar obat formularium lengkap dan merupakan ketentuan rumah sakit yang berlaku. Penyebab ketidak patuhan terhadap penggunaan obat generik disebabkan obat dimaksud tidak ada sediaan generiknya, permintaan pasien dan status klinis pasien.
Background : Sardjito Hospital was founded in 1982, for periods until 1989 Sardjito hospital do not have a hospital formulary. Pharmacy Services is not optimal, drug expiring, stock over or stock out of drugs became major problems in drug policy in this period. In 1990 Sardjito Hospital has a hospital formulary, the formulary had revised first in 1998 and then in 2000, last revision of hospital formulary conducted 1n 2002. On other parts, hospital management bring out policy in application of generic drugs based on class of care. Purpose : To identify doctor’s compliance using 2002 hospital formulary and generic drug usage according to the class of care, and doctor’s perception to formulary and generic drug application. Method : A descriptive-analytic research was performed. The subject of this research were doctors placed in Internal Medicine Ward (IRNA I) in July 2002 – June 2003 periods. Drugs prescribe data acquired from Drugs Distribution Instruction Card (KIPO), retrospectively, including percentage of drug in conformity with 2002 formulary, percentage of generic drugs and patent drugs, and percentage of antibiotic application. Perception data using close questionnaire by Likert scale, and compliance data using an open questionnaire. Results and Conclusions : The result shows that in average 85,19% drugs application match with formulary which consist of 34,53% use generic drugs and 50,66% use patent drugs. For antibiotics drugs were prescribed in 15,03% case and percentage of generic drugs usage in ward was 44,27%. Percentage of prescribing generic drugs are 38,44% in first class, 41,53% in second class, and 43,87% in third class. In doctor’s perception regarding formulary shows that group of doctor with medium perception on formulary are bigger than group of doctor with high perception on formulary. The same condition occurs in perception of generic drugs usage when group of doctor with medium perception are bigger than group of doctor with high perception on generic drugs usage. Conclusions : Compliance using formulary is not optimal, rate of generic drugs is low and generic drugs application according to the class of care is not suitable with certainly regulation. The compliance in usage of hospital formulary in influenced by availability of formulary drugs, formulary drug list is complete and supported by hospital regulation. No compliance in generic drugs usage is caused by generic drugs for drugs regiment asked is unavailable, patient request, and clinical status from patients.
Kata Kunci : Manajemen Rumah Sakit, Kepatuhan Formularium 2002, Obat Generik
