Development of a module for the prevention of nonsteroidal anti-inflammatory drugs-associated gastrointestinal adverse reactions in the elderly at a primary health center

Article type: Research Article

Authors: Siregar, Alyya Siddiqa^{a; b} | Werdhani, Retno Asti^c | Ascobat, Purwantyastuti^d; | Nafrialdi, Nafrialdi^d | Syam, Ari Fahrial^e | Hidayat, Rudy^e | Wangge, Grace^f

Affiliations: [a] Doctoral Program in Medical Sciences, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia | [b] Department of Pharmacology, Faculty of Medicine, State Islamic University Syarif Hidayatullah Jakarta, Jakarta, Indonesia | [c] Department of Community Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia | [d] Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia | [e] Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia | [f] South East Asian Ministers of Education Organization – Regional Center for Food and Nutrition (SEAMEO-RECFON), Pusat Kajian Gizi Regional University of Indonesia (PKGR UI), Jakarta, Indonesia

Correspondence: [*] Address for correspondence: Purwantyastuti Ascobat, Professor, PhD, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jalan Salemba Raya No. 5, Kenari, Senen, Jakarta Pusat, Daerah Khusus Ibukota Jakarta, 10430, Indonesia. Tel.: +62 816713064; Fax: +62 21 3920947; E-mail: [email protected]

Abstract: BACKGROUND:The prevention of nonsteroidal anti-inflammatory drugs (NSAIDs) adverse reactions should start from the primary health center (PHC), as the first gatekeeper in community health services. However, there is no specific module available for health care professionals (HCPs) in Indonesia for the prevention of adverse drug reactions (ADR) at PHCs. NSAID is commonly used for the elderly treated at PHC in Indonesia, even though the ADR risk is well-known. OBJECTIVE:We aimed to develop a module to be used in PHC for preventing NSAID-associated upper gastrointestinal (GI) ADRs in elderly patients treated for musculoskeletal diseases. METHODS:The module was developed based on inputs from focus group discussions (FGD) among government health officers, PHC representatives, clinical pharmacologists, internal medicine and community medicine clinicians, pharmacovigilance experts, and professional organizations. A pilot implementation was conducted to test its feasibility and its effect on the HCPs’ knowledge. RESULTS:Capacity building of HCPs, development of intra-HCP cooperation, as well as standard operating procedure (SOP) for the prescription of NSAID constituted important components of the module. A pilot study of the module in two PHCs showed that it was applicable with some recommendations for improvement in duration, number of participants, room space, presentation, and use of credit points as compliments. The HCPs’ knowledge was improved after following the module. CONCLUSIONS:Our study showed that the module is feasible in PHC in Indonesia and useful in improving knowledge of HPC.

Keywords: NSAIDs, primary health center, health care professional, elderly, adverse drug reactions, Indonesia

DOI: 10.3233/JRS-200008

Journal: International Journal of Risk & Safety in Medicine, vol. 32, no. 1, pp. 61-73, 2021