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Cited by 106Antibiotic Use and ResistancePharmacy and Medical PracticesPharmaceutical Practices and Patient Outcomes

The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.

Small group intervention vs formal seminar for improving appropriate drug use

Santoso, Budiono·1996·Social Science & Medicine
DOI 10.1016/0277-9536(95)00390-8
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Abstract

In an attempt to evaluate the efficacy of different methods of interventions to improve the appropriate use of drugs for acute diarrhoea, a controlled study has been carried out in 6 districts in Yogyakarta and Central Java provinces, Indonesia. This study was designed to investigate the impacts of two different methods of educational intervention, i.e. a small group face-to-face intervention and a formal seminar for prescribers, on prescribing practice in acute diarrhoea. The districts were randomly assigned into 3 groups and 15 health centers were selected from each district. Prescribers in Group 1 underwent a small group face-to-face intervention conducted in the respective health center. Those in Group 2 attended a formal seminar conducted at the district level. Prescribers in Group 3 served as the control group. Both interventions were given on a single occasion without follow-up supervision or monitoring. Written information materials on the appropriate management of acute diarrhoea were developed and were provided to all prescribers in the intervention groups. Focus group discussions (FGDs) involving prescribers and consumers in the 6 districts were carried out to identify various underlying motivations of drug use in acute diarrhoea. The findings of the FGDs were used as part of the intervention materials. To evaluate the impacts of these interventions on prescribing practice, a prescribing survey for patients under five years old with acute diarrhoea was carried out in health centers covering 3-month periods before and after the intervention. The results showed that both interventions were equally effective in improving the levels of knowledge of prescribers about the appropriate management of acute diarrhoea. They were also partially effective in improving the appropriate use of drugs, reducing the use of non-rehydration medications. There was a highly significant reduction of antimicrobial usage either after small-group face-to-face intervention (77.4 +/- 2.7% to 60.4 +/- 2.9%; P < 0.001) or formal seminar (82.3 +/- 3.0% to 72.3 +/- 3.6%; P < 0.001), and the former caused significantly (P < 0.001) greater reduction than the latter. There was also a significant (P < 0.01) reduction in the usage of antidiarrhoeals after both interventions, i.e. from 20.3 +/- 3.7% to 12.5 +/- 3.3% (P < 0.01) after face-to-face intervention and from 48.5 +/- 4.1% to 27.0 +/- 4.3% (P < 0.01) after seminar. However, the formal seminar had a significantly (P < 0.01) greater impact than the small group face-to-face intervention. There was also a trend toward increased oral rehydration solution (ORS) usage after both interventions, but this did not achieve the level of statistical significance (P > 0.05). No changes were observed in the control group. Although the small group face-to-face intervention did not appear to offer greater impacts over large seminars in improving the appropriate use of drugs in acute diarrhoea, since the unit cost of training is far less costly than the seminar, it might be feasibly implemented in the existing supervisory structure of the health system.

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Crossref · 10.1016/0277-9536(95)00390-8

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Research works printed but not linked: 2

  1. Soumerai, 1987, Changing the unchangeable: principles and experiences in improving prescribing accuracy, World Pediatr. Child Care, 3, 287
  2. Laing, 1991, What changes behaviour?, Dialogue on Diarrhoea, 45, 6

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Metadata

Authors
Santoso, B.
Affiliations
Universitas Gadjah Mada (ID)
Corresponding author
Santoso, Budiono
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
1996-04
Volume
42
Issue
8
Pages
1163-1168
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/0277-9536(95)00390-8
OpenAlex
W2051118092
Cited by
106
References
9
Citations by year
2026: 1 · 2024: 1 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 1 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 2
FWCI
2.98
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
acute diarrhea, rational drug use, prescribing patterns, small group intervention, prescriber education, antimicrobial use, antidiarrheal agents, rehydration therapy, children under five, health centers, intervention efficacy, Yogyakarta, Central Java, Indonesia, focus groups
MeSH terms
Acute Disease, Anti-Bacterial Agents, Antidiarrheals, Child, Child, Preschool, Developing Countries, Diarrhea, Female, Fluid Therapy, Health Services Misuse, Humans, Indonesia, Infant, Inservice Training, Health Knowledge, Attitudes, Practice, Male, Pharmaceutical Services, Drug Prescriptions, Drug Utilization Review

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