Indonesian Pharmacists' Application of Beyond-Use Date Interventions to Patients and Its Contributing Factors: A Cross-Sectional Study

Hosp Pharm. 2023 Dec;58(6):628-633. doi: 10.1177/00185787231179833. Epub 2023 Jun 16.

Abstract

Background: Extemporaneous preparations are commonly used in Indonesia, hence, Beyond-Use Date (BUD) information needs to be delivered by pharmacists to patients to maximize drug stability and enhance safety. Objective: This study aims to evaluate BUD interventions carried out by Indonesian pharmacists. Methods: A cross-sectional design was used, while a validated and reliable questionnaire was given to the samples using the snowballing and purposive sampling methods. The sample criteria were Indonesian pharmacists who had experience serving patients' extemporaneous prescriptions and those that completed the questionnaire. The significance of the relationship between BUD interventions and samples' characteristics was evaluated using the Mann-Whitney U test. Results: From the 221 total respondents, the majority admitted that they always provide BUD labeling on crushed tablets 46%, syrup 50.7%, and ointment 49.6% extemporaneous preparations. Similarly, most of the respondents also affirmed that they always provided BUD verbal information to patients on crushed tablets 66.8%, syrup 68%, and ointment 64% extemporaneous preparations. However, the remaining pharmacists, ranging from 32% to 54%, acknowledged that they did not always deliver both BUD labeling and verbal information to patients. Compared to the community-based, hospital pharmacists provided BUD labeling more frequently on all extemporaneous formulations as demonstrated by P < .05. Additionally, pharmacists found to work in Jakarta and the surrounding areas provided substantially more BUD labeling on crushed tablets and ointment (P < .05) compared to other workplace. Adult pharmacists also provided BUD labeling on crushed tablet formulations more often than the middle-aged (P < .05). Only the crushed tablet preparation was associated with the provision of BUD verbal information (P = .004). Conclusions: Based on the results, not all pharmacists verbally inform patients about BUDs nor provide drug labeling on various extemporaneous preparations. The determinant factors contributing to BUD labeling provisions were the type of practice, workplace location, and age. For the provision of verbal information, the only determinant factor was the type of practice.

Keywords: Beyond-Use Date; Indonesian pharmacists; non-sterile compounding drugs.