Hanni P Puspitasari

Departemen Farmasi Komunitas

Fakultas Farmasi Universitas Airlangga
2015
 Pharmacists as public health
practitioners
 Improving public health through
pharmacy
 Developing pharmacy public health
services

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 The global burden of communicable diseases
 The global burden of non-communicable diseases
(chronic diseases)
• TB paru • Demam
• HIV & AIDS berdarah
• Penyakit jantung & pembuluh • Pneumonia dengue
darah • Kusta (DBD)
• Penyakit kanker • Diare • Chikungunya
• Penyakit diabetes melitus dan • Penyakit dapat • Filariasis
penyakit metabolik, termasuk dicegah dengan • Malaria
obesitas, dislipidemia, ggg. klj. imunisasi • Rabies
tiroid, klj. hipotalamus, metab. (PD3I): tetanus • Leptospirosis
kalsium, sekresi korteks adrenal neonatorum, • Antraks
• Penyakit kronis & degeneratif, campak, • Flu burung
PPOK, asma, osteoporosis, SLE, difteri, polio &
osteoartritis, rhinitis, ggl ginjal AFP
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 The global burden of communicable diseases
 The global burden of non-communicable diseases
(chronic diseases)
Beban
penyakit di
INDONESIA

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 The global burden of communicable diseases
 The global burden of non-communicable diseases
(chronic diseases)
Beban
penyakit di
INDONESIA

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 Settings:
 Primary care  health education, protection, prevention
 Disposal of waste medicines, “brown bag” program
 Vaccination clinics: influenza, hepatitis B, tetanus, diphteria
 Methadone maintenance treatment, needle exchange services
 Sexual health services: emergency contraception, HIV testing
 Smoking cessation services: nicotine replacement therapy
 Healthy weight management
 Secondary care  detection & resolution of medication-
related errors
 Pharmaceutical industry  R&D, pharmacovigilance
 Academic pharmacy  pharmacy practice research
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 Health promotion
 Health education Health
 Health protection education

 Prevention
 Primary prevention
 Secondary prevention Health
Prevention
protection
 Tertiary prevention

 Medicine management
Tannahill’s model of
health promotion

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 Health promotion • Communication of information
• Motivation, development of skills
 Health education
and confidence
 Health protection
 Prevention • Regulations and policies
 Primary prevention • Healthy individuals
 Secondary prevention
 Tertiary prevention • Individuals with disease(s)

 Medicine management

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 Health promotion
 Health education
 Health protection
 Prevention Strategies:
 Primary prevention  Focus on individuals
 Secondary prevention  Focus on groups
 Tertiary prevention  Focus on populations
• Social marketing and the
 Medicine management media
• Community approaches:
community development
• Environmental approaches:
healthy public policy,
regulation, legislation
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 Authoritative form
 Health promotion
 Health education
 Health protection Health Legislative

Individual focus

Collective focus
persuasion action
 Prevention
 Primary prevention
 Secondary prevention
 Tertiary prevention Personal Comm.
 Medicine management counseling developm.

Negotiated form
Beattie’s strategies of
health promotion
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 Health promotion
 Health education
 Health protection

Individual focus
 Prevention Changing behaviour
 Primary prevention • The Health Belief Model
 Secondary prevention • The Theory of Reasoned
 Tertiary prevention Action
• The Theory of Planned
 Medicine management Behaviour
• The Theory of Trying
• The Transtheoretical
Model
• The Social Learning
Theory Model
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 Health promotion
 Health education
 Health protection

Individual focus
 Prevention Changing behaviour
 Primary prevention
 Secondary prevention
 Tertiary prevention

 Medicine management

• Behavioural support
• Pharmacotherapy

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 • Cardiovascular
 Health promotion disease risk: BP,
 Health education HDL, LDL, TC
 Health protection • Type-2 diabetes
• Cancer: breast,
 Prevention cervical, bowel,
 Primary prevention prostate
Screening
 Secondary prevention • Asthma control
 Tertiary prevention • Infectious
diseases in
 Medicine management
pregnancy
• Chlamydia (STI)
• Mental health
• Sleep disorders

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  Ensuring cost-effective use of
 Health promotion
medicines within populations
 Health education • Influencing prescribing:
 Health protection formularies, guidelines
 Prevention • Monitoring prescribing:
analysis of prescribing data,
 Primary prevention
drug utilization reviews,
 Secondary prevention clinical audit
 Tertiary prevention  Ensuring safe use of
 Medicine management medicines within populations
• Pharmacovigilance
 Communicating medicines
management issues (patients
& health professionals)  safe,
effective, rational
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 Health needs assessment
 Need: what people benefit from Demand
 Demand: what people ask for
 Supply: healthcare provision
 Epidemiological studies Need Supply
 Involving patients and the public

 Evidence-based pharmacy practice

 Working in partnership

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 Health needs assessment
 Need: what people benefit from TREATMENT EFFECT
 Demand: what people ask for • Randomised
 Supply: healthcare provision controlled trials
 Epidemiological studies
• Meta-analyses
• Systematic reviews
 Involving patients and the public
• Case control
 Evidence-based pharmacy practice studies
• Cohort studies
 Working in partnership • Case report
• Case series
• Expert opinion
ECONOMIC EVAL.
• CMA, CEA, CUA
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 Health needs assessment
 Need: what people benefit from
 Demand: what people ask for
 Supply: healthcare provision
 Epidemiological studies
 Involving patients and the public

 Evidence-based pharmacy practice

 Working in partnership • Different health professionals
• Different practice settings
• Different organisations
• Community leaders, members
• Internal pharmacy members
• The government
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 Egger G, Spark R, Donovan R, 2005. Health promotion
strategies and methods, 2nd ed. North Ryde: McGraw
Hill.
 Kementerian Kesehatan RI, 2014. Profil kesehatan
Indonesia 2013. Jakarta: Kementerian Kesehatan RI.
 Krska J, 2011. Pharmacy in public health, London:
Pharmaceutical Press.

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