The role of clinical reminder system to drug prescribing on patients of the National Health Insurance with ischemic stroke

https://doi.org/10.19106/JMedSci005402202204

Faramita Hiola(1*), Iwan Dwiprahasto(2), Rizaldy Pinzon(3)

(1) Faculty of Sports and Health, Universitas Negeri Gorontalo, Gorontalo, Indonesia
(2) Department of Pharmacology and Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta
(3) Department of Neurology, Bethesda Hospital, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Since 2014 Indonesia has entered the era of universal health coverage (UHC) and public health financing system managed by the Social Security Organizing Agency Law/SSOAL (Badan Penyelenggara Jaminan Sosial/BPJS) . In this system, a national formulary was used as the basis for prescribing drugs by clinicians. One effort for quality and cost control in UHC was to develop a clinical reminder system (CRS) to help prescriber set treatment options in accordance with the national formulary.  The aim of this study was to measure the role of CRS to the compatibility of drug prescribing in patients with ischemic stroke in Bethesda Hospital Yogyakarta, Indonesia. This study was carried out using quasi-experimental with pre-test and post-test design. The subjects of this study were outpatient ischemic stroke and the National Health Insurance (NHI) participant, age >18 years and had complete medication data. Prescribing data were compared between stroke patients treated at the hospital before and after implementation of CRS. The study was performed in 200 National Health Insurance (NHI) scheme outpatients with ischemic stroke. The groups consisted of 100 patients without CRS and 100 patients with CRS. The basic characteristics of both groups were similar. The results showed that after implementation of CRS, a significant improvement in the compliance of the neurologist prescribing medicine used to be available only in national formulary (RR: 1.02; 95% CI=1.00-1.04; p=0.015). Among others the most significant improvement was the prescription of antidyslipidemic using HMG-CoA medicine available in formulary. In conclusion, CRS can improve the compliance of prescribing with national formulary in stroke ischemic patients.


Keywords


clinical reminder system; stroke; prescription; universal health coverage; national formulary

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References


1.BPJS Kesehatan. Pentingnya dukungan pemda untuk mencapai universal health coverage. BPJS Kesehatan 2016: 3-12.
2.Kementerian Kesehatan RI. Formularium Nasional kendalikan mutu dan biaya pengobatan. Pusat Komunikasi Publik Sekretariat Kementerian Kesehatan RI, 2013. http://www.kemenkes.go.id.
3.Tadi P, Lui F. Acute Stroke. [Updated 2021 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
https://www.ncbi.nlm.nih.gov/books/NBK535369/
4.Stroke foundation. Clinical guidelines for stroke management, 2017. Available from: https://informme.org.au/guidelines/clinical-guidelines-for-stroke-management
5.Kementerian Kesehatan RI. Formularium nasional. Jakarta: Kementerian Kesehatan RI, 2014.
6.Anonim. Laporan hasil riset kesehatan dasar (Riskesdas) national 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan, 2014.
7.Matheny ME, Sequist TD, Seger AC, Fiskio JM, Sperling M, Bugbee D, et al. A randomized trial of electronic clinical reminders to improve medication laboratory monitoring. J Am Med Inform Assoc 2008; 15(4):424-9.
https://doi.org/10.1197/jamia.M2602.
8.Pinzon RT, Priskila L. Sistem pengingat klinis untuk meningkatkan kepatuhan peresepan berdasarkan formularium di RS Bethesda. J Hosp Accred 2019;1(1):24-26.
https://doi.org/10.35727/jha.v1i1.16
9.American Heart Association. Quideline for the early management of patients with acute ischemic stroke. Update, American Heart Association/American Stroke Association, 2013.
10.Diamond H, Johnson MP, Padman R, Zheng K, Payne VL. Clinical reminder system: a relational database application for evidence-based medicine practice. Spring National Conference 2004; 1-35.
11.Youssef A, Almubarak A, Alnuaimi M, Alshehri B, Ghayda A, Akkari K, et al. Contraindicated medications administered to inpatients with renal insufficiency in a Saudi Arabian hospital that has a computerized clinical decision support system. J Taibah Univ Med Sci 2015:1–7.
http://dx.doi.org/10.1016/j.jtumed.2015.02.012.
12.Foster JM, Usherwood T, Smith L, Sawyer S, Xuan W, Rand CS, et al. Inhaler reminders improve adherence with controller treatment in primary care patients with asthma. J Allergy Clin Immunol 2014; 134(6):1260-8.e3.
https://doi.org/10.1016/j.jaci.2014.05.041
13.Food and Drug Administration. Generic drug facts 2018. Quintiles IMS Institute: Reports, 2018.
14.Sequist TD, Gandhi TK, Karson AS, Fiskio JM, Bugbee D, Sperling M, et al. A randomized trial of electronic clinical reminders to improve quality of care for diabetes and coronary artery disease. J Am Med Inform Assoc 2005; 12(4):431-7.
https://doi.org/10.1197/jamia.M1788
15.Filippi A, Sabatini A, Badioli L, Samani F, Mazzaglia G, Catapano A, et al. Effects of an automated electronic reminder in changing the antiplatelet drug–prescribing behavior among italian general practitioners in diabetic patients: an intervention trial. Diabetes Care 2003; 26(5):1497-500.
https://doi.org/10.2337/diacare.26.5.1497



DOI: https://doi.org/10.19106/JMedSci005402202204

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