Konsep Penggunaan Obat

Secara Bijak
Steps of Rational Treatment

• Step1: Define the patient's problem

• Step 2: Specify the therapeutic objective
• What do you want to achieve with the treatment?
• Step 3: Verify the suitability of your P-treatment
Check effectiveness, safety and suitability
• Step 4: Start the treatment
• Step 5: Give information, instruction and warnings
• Step 6: Monitor (and stop?) treatment
Selecting your P(ersonal) Medicines

• I. Define the diagnosis

• II. Specify the therapeutic objective
• III. Make an inventory of effective groups of medicines
• IV. Choose an effective group according to criteria

Choose a P-medicine
Choose an effective group according to criteria

1. Efficacy
2. Safety Empat Pilar Mutu Dalam
Penggunaan Obat
3. Suitability
4. Affordability
Treating Your Patients
Step 1: Define the Patient's Problem

• Disease or disorder
• Sign of underlying disease
• Psychological or social problems, anxiety
• Side effect of medicines
• Refill request (polypharmacy)
• No-adherence to treatment
• Request for preventive treatment
• Combinations of the above
Step 2: Specify the therapeutic objective

• Prevent a lot of unnecessary medicine use

• Avoiding unnecessary prophylactic especially antibiotic

There is a good idea to discuss the therapeutic objective

with the patient, that will lead in adherence to treatment
Step 3: Verify the suitability of your P-medicine
• Active substance and dosage form
• Standard dosage schedule
• Standard duration of treatment

• For each these, check:

– Effectiveness (indication, convenience)
– Safety (contraindications, interactions, high risk group)
Step 4:
write prescription/ recommendation of the medicines
Step 5: Give Information, Instructions and warnings
• Effects of the medicine
• Side effects
• Instructions
• Warnings
• Future consultations
• Everything clear?
Step 6: Monitor (and stop?) the treatment

Was the treatment effective?

a. Yes, and disease cured : stop the treatment
b. Yes, but not yet completed: any serious side effects?
– No : treatment can be continued
– Yes: reconsider dosage or medicine choice
c. disease not cured : verify all steps
• Diagnosis correct?
• Therapeutic objective correct?
• P-med suitable for this patient?
• Medicine prescribed correctly?
• Patient instructed correctly?
• Effect monitored correctly?
Summary

Penggunaan Obat secara Bijak :

– Peresepan
– Dispensing
– Monitoring