INTRODUCTION
Limited
public knowledge about drugs and their use can lead to medication errors,
especially when people do self-medication. According to WHO, self-medication is
considered as the selection and use of modern medicine, herbs, and traditional
medicine by an individual to treat illness or symptoms of illness. Self Medication is a choice taken by the community to
increase the affordability of treatment with the aim of relieving or curing
minor health complaints such as fever, dizziness, cough, flu, pain, ulcers,
diarrhea and others without consulting medical practitioners and without
medical supervision (Kartajaya, Taufik, Iwan, Bayu, &
Nastiti, 2011);
(Ocan et al., 2015); (Nining, 2019). In
short, self medication is a community effort to treat
themselves (Departemen Kesehatan, 2006).
Self-medication is carried out if the patient gets medicines without a
prescription, buys medicines based on old prescriptions, gives them from
friends or family medicines, or uses leftover medicines (Adhikary, Tiwari,
Singh, & Karoo, 2014).
Swamedikasi has risks such as fault
diagnosis, the use of excessive drug dosage, as well as long-term use can cause
adverse effects on society (Mamo, Ayele, &
Dechasa, 2018). Practice
of� swamedikasi
can lead to the use of drugs is not exactly that cause drug interactions,
resistance and side effects of drugs such as its sensitivity, allergy, shock
and even other losses such as inaccuracy of diagnosis, use of drugs that are
sometimes not appropriate, a waste of time to charge (Jajuli & Kurnia,
2018); (Nining, 2019).
Basically, the drugs chosen by the community in the practice of community
self-medication are influenced by several factors such as product
advertisements, treatment experience, economic conditions, psychological
conditions, knowledge and educational history (Kalungia, Burger,
Godman, Costa, & Simuwelu, 2016). Even the
clans that circulate on television usually do not convey complete information
about a drug or its use . Based on data from the Food
and Drug Supervisory Agency, drug advertisements on television, print media and
radio do not comply with drug advertising regulations (Cahaya, Adawiyah,
& Intannia, 2018).
The practice of self-medication
is most often found in pharmacies. Pharmacy is a pharmaceutical service
facility where pharmacists practice pharmacy (KemenKes,
2016). The role of pharmacists is described in 9 Stars of Phamacist
by the World Health Organization (WHO), namely care-giver, decision-maker,
communicator, manager, leader, life long learner,
teacher, research, and entrepreneur. This is in line with the role of
pharmacists as stated in the Peraturan Kementerian
Kesehatan 73 of 2016, namely:
1.
Service provider.
Pharmacists as service providers must interact with patients. Pharmacists must
integrate their services into the health care system on an ongoing basis.
2.
Decision maker. Pharmacists
must have the ability to make decisions by using all available resources
effectively and efficiently.
3.
Communicator. Pharmacists
must be able to communicate with patients and other health professionals
regarding patient therapy. Therefore, you must have good communication skills.
4.
Leader. Pharmacists are
expected to have the ability to become leaders. The expected leadership
includes the courage to make empathetic and effective decisions, as well as the
ability to communicate and manage the results of decisions.
5.
Manager. Pharmacists must be
able to manage human, physical, budgetary and information resources
effectively. Pharmacists must keep abreast of advances in information
technology and be willing to share information about Drugs and other matters
related to Drugs.
6.
Lifelong learner.
Pharmacists must continue to improve knowledge, attitudes and professional
skills through continuing education (Continuing Professional Development / CPD)
7.
Researcher
. Pharmacists must always apply scientific principles/rules in collecting
information on Pharmaceutical Preparations and Pharmaceutical Services and
using it in the development and implementation of Pharmaceutical Services.
Therefore, pharmacists are
required to be able to provide appropriate information to the public so that
people can avoid the use of drug misuse and drug abuse through good
communication. Good communication and taking place on an equal basis (not
superior-inferior) is needed so that patients can provide the information
needed by pharmacists to help them.
METHOD
The preparation of this review article was carried out
using a descriptive method with a literature review approach. With this method,
the author wants to describe, build a concept or theory that is the basis of
study in research.
RESULTS
AND DISCUSSION
The process of
self-medication mostly occurs in pharmacies. Based on the answers from the
respondents, it is known that the level of knowledge of respondents about
self-medication and procedures is quite good. Respondents know about
self-medication and procedures as much as 71.4% and 28.6% do not. Even so, all
respondents 100% knew that a pharmacist had an important role in the
self-medication process at the pharmacy. This means that the respondents are
fully aware of their important role and existence, even though they do not know
the procedure.
In Peraturan Menteri Kesehatan 73 of 2016 it is stated
that one of the roles that a pharmacist must have is as a communicator. A
pharmacist is required to be a good source of information for patients. Based
on the results of the correspondence answers, as many as 65.2% of them knew
about the 9 Stars of Phamacist by the World Health Organization (WHO ), while
the other 34.8% did not know it. A total of 69.6% know about Peraturan Menteri Kesehatan No. 73 of 2016 concerning
Pharmaceutical Service Standards, while 30.4% did not. This shows that the
level of knowledge of prospective pharmacists is in the good category, although
there are some people who do not know it. This is a concern because of the� 9 Stars of Phamacist by the World Health
Organization and Peraturan Menteri Kesehatan No. 73 of 2016 is the basis for the
implementation of services for a pharmacist. In the 9 Stars of Phamacist by the
World Health Organization and Peraturan Menteri Kesehatan No. 73 of 2016 explained that one of
the roles that a pharmacist must have is as a communicator. A pharmacist is
required to be a good source of information for patients.
The
communication requested is not only verbal communication but also nonverbal
communication. Verbal communication includes words in the form of information,
questions to patients, and motivation to patients. While nonverbal
communication is behavior during interaction with patients. For example, if
there is a patient who wants to buy or pick up medicine at a pharmacy, a
pharmacist is expected to provide the information needed by the patient such as
the name of the drug, its uses and side effects, as well as things to avoid
when taking the drug. Information is also needed so that patients can use drugs
according to their needs. It is also important to minimize medication errors
that occur due to lack of information from pharmacists. There are 16 procedures
that must be carried out by pharmacists when dealing with patients (Departemen Kesehatan, 2006),
namely:
1.
Pharmacist
introduces himself
2.
Identification:
whether the patient comes alone or not
3.
Ask
the patient if he or she has time to be briefed and explain the benefits of
counselling.
4.
Asking
the patient if the doctor has explained the drug given.
5.
Listen
to all patient statements carefully and empathetically.
6.
Ask
if there is a history of allergies
7.
Explain
to the patient the name of the drug, indications, how to use it.
8.
Explain
to the patient about the dose, frequency and duration of use of the drug.�
9.
Make
a medication schedule that is tailored to the patient's daily activities and
ask if the patient has difficulty following the schedule.
10. Explain the necessary actions if you forget to take
your medicine
11. Explaining things that need to be avoided while taking
medication
12. Describe possible drug-drug, or drug-food
interactions and how to deal with them
13. Explain side effects and how to deal with side
effects
14. Explain how to store properly
15. Ensure the patient understands all the information
provided by asking the patient to repeat it.
16. Document all important information
In
other sources, self-medication services can be carried out by applying the
WWHAM (What, What Symptoms, How Long, Action, Medicine) method which contains 5
systematic guiding questions to gather information from pharmacy visitors who
ask for drugs without a prescription. The questions for self-medication
services can be seen in the following table:
During
the communication process, pharmacists must also be able to interact with
nonverbal communication. Pharmacists must be able to see the situation and
condition of the patient. Pharmacists are required to be able to make patients
communicate in a calm state. This is where the pharmacist's nonverbal
communication skills are tested. The patient's anxiety, panic, or embarrassment
are nonverbal signs that a pharmacist should pay attention to. When the patient
panics, the patient cannot explain his condition calmly and causes the
pharmacist to be unable to help. For this reason, pharmacists must have the
ability to deal with these conditions. Nonverbal communication is as important
as verbal communication. A pharmacist can certainly provide information about
the drug that the patient needs, but not all pharmacists are able to provide a
sense of comfort when explaining it. Several cases were found when the patient
did self-medication, the pharmacist was unfriendly so that the patient could
not explain the pain he was suffering from. As a result, the patient's efforts
to recover were not achieved. Poor patient relations can be seen from how
pharmacists treat patients in nonverbal communicati.
CONCLUSION
The practice of
self-medication is unavoidable, so what a pharmacist can do is to monitor it.
When self-medication occurs, the pharmacist must be able to provide the
information that the patient needs. Good communication consisting of verbal and
nonverbal communication is an ability that must be possessed by pharmacists.
Good communication makes the patient feel healed even before taking the
medicine.
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