International Journal of Clinical Pharmacy

, Volume 37, Issue 5, pp 873–882 | Cite as

Evaluation of community pharmacy-based services for type-2 diabetes in an Indonesian setting: pharmacist survey

  • Yosi WibowoEmail author
  • Richard Parsons
  • Bruce Sunderland
  • Jeffery Hughes
Research Article


Background Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. Objectives To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Setting Community pharmacies in a developing country setting (Surabaya, Indonesia). Methods A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists’ perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. Results A response rate of 60 % was achieved. Dispensing (100 %) and education on how to use medications (72.6 %) were common current pharmacy practices. More than 50 % of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6 %) and common/important adverse effects (25.7 %)], education on exercise (36.5 %), education on diet (47.7 %), and monitoring medication compliance (27.9 %). Facilitators identified were: being perceived as part of a pharmacist’s role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists’ involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Conclusions Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.


Community pharmacist Diabetes Indonesia Pharmacy services 



We thank all the participants who took part in the survey as well as Ikatan Apoteker Indonesia—IAI (Indonesian Pharmacists Association) and staff from the Centre of Medicines Information and Pharmaceutical Care (CMIPC), Pharmacy Faculty, Universitas Surabaya, for their technical support in making this study possible.


This study formed part of a doctoral thesis funded by an AusAID scholarship, which is a part of Australia’s education assistance to Indonesia.

Conflicts of interest

We have no conflicts of interest to disclose. Part of this research was presented as a poster at the FIP Centennial Congress in Amsterdam, 3–8 October 2012.

Ethical standard

This study was approved by the Human Research Ethics Committee of Curtin University (PH-09-11) and Ikatan Apoteker Indonesia—IAI (Indonesian Pharmacists Association) (001/SK/BPD-IAI/SURABAYA/2010).

Supplementary material

11096_2015_135_MOESM1_ESM.doc (369 kb)
Supplementary material 1 (DOC 369 kb)


  1. 1.
    Badan Pusat Statistik (BPS). Sensus penduduk 2010 [The 2010 population census] [Internet]. Jakarta: BPS; 2010 [cited 14 Jan 2015].
  2. 2.
    International Diabetes Federation (IDF). IDF Diabetes Atlas 6th edition [Internet]. Brussels: IDF; 2013 [cited 6 Jan 2015]. ISBN: 2930229853.
  3. 3.
    Soewondo P, Soegondo S, Suastika K, Pranoto A, Soeatmadji D, Tjokroprawiro A. The DiabCare Asia 2008 study: outcomes on control and complications of type 2 diabetic patients in Indonesia. Med J Indones. 2010;19(4):235–44.CrossRefGoogle Scholar
  4. 4.
    Soewondo P, Ferrario A, Tahapary D. Challenges in diabetes management in Indonesia: a literature review. Glob Health. 2013;9(1):63.CrossRefGoogle Scholar
  5. 5.
    Wang H, McEuen M, Mize L, Cisek C. Private sector in Indonesia: a desk review [Internet]. Bethesda: Health Systems 20/20 project Abt Associates Inc.; 2009 [cited 9 Jan 2015].
  6. 6.
    Pemerintah Republik Indonesia. Peraturan Pemerintah nomor 51 tahun 2009: pekerjaan kefarmasian [Government Regulation number 51 of 2009: pharmacy practice]. Jakarta: Pemerintah Republik Indonesia; 2009.Google Scholar
  7. 7.
    Kementrian Kesehatan Republik Indonesia (Kemenkes RI). Keputusan Menteri Kesehatan nomor 1027/MENKES/SK/IX/2004: standar layanan kefarmasian di apotek [Ministry of Health Decree number1027/MENKES/SK/IX/2004: standards for pharmaceutical care in community pharmacies]. Jakarta: Kemenkes RI; 2006.Google Scholar
  8. 8.
    Simpson S, Haggarty S, Johnson J, Schindel T, Ross T, Lewanczuk R. Survey of pharmacist activities and attitudes in diabetes management. Can Pharm J. 2009;142(3):127–34.CrossRefGoogle Scholar
  9. 9.
    Douglas E, Power A, Hudson S. Pharmaceutical care of the patient with diabetes mellitus: pharmacsts’ priorities for services and educational needs in Scotland. Int J Pharm Pract. 2007;15(1):47–52.CrossRefGoogle Scholar
  10. 10.
    Abduelkarem A, Sackville M, Morgan R, Sackville M, Hildreth A. Views and practices of community pharmacists regarding services for people with type 2 diabetes. Int J Pharm Pract. 2003;11(3):161–8.CrossRefGoogle Scholar
  11. 11.
    Younis W, Campbell S, Slack M. Pharmacists’ attitudes toward diabetes and their involvement in diabetes education. Ann Pharmacother. 2001;35(7):841–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Kjome R, Sandberg S, Granås A. Diabetes care in Norwegian pharmacies: a descriptive study. Pharm World Sci. 2008;30(2):191–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Plake K, Chesnut R, Odorzynski M. Barriers to community pharmacists’ provision of diabetes care services in Iowa. J Pharm Technol. 2007;23(6):327–38.CrossRefGoogle Scholar
  14. 14.
    Storimans J. Pharmaceutical care in diabetes: quantifying and evaluating community pharmacy’s support to patients performing blood glucose self-monitoring [dissertation]. Uthrecht: Utrecht University; 2005.Google Scholar
  15. 15.
    Purwanti A, Harianto, Supardi S. Gambaran pelaksanaan standar pelayanan farmasi di apotek DKI Jakarta [Implementation of the standards for pharmacy services in community pharmacies in Jakarta]. Maj Ilmu Kefarmasian. 2004; 1(2):102–115.Google Scholar
  16. 16.
    Herman M, Sasanti R, Raharni, Siahaan S. Analisis faktor internal dan eksternal yang terkait dengan model pelayanan prima di apotek [Analysis of internal and external factors related to the model of extended services in community pharmacies]. Bul Penelit Sist Kesehat. 2008; 11(2):145–155.Google Scholar
  17. 17.
    Herman M, Susyanty A. Kajian praktek kefarmasian oleh apoteker di apotek komunitas [Evaluation of pharmacist practices in community pharmacies]. Bul Penelit Sist Kesehat. 2012;15(3):271–81.Google Scholar
  18. 18.
    Zurmatias R. Pharmaceutical services in community pharmacy in Jakarta [dissertation]. Bangkok: Chulalongkorn University; 2007.Google Scholar
  19. 19.
    Pemerintah Kota Surabaya. Demografi [Demographic data] [Internet]. Surabaya: Pemerintah Kota Surabaya; 2012 [cited 15 Jan 2015].
  20. 20.
    Airlangga Universitas. Daftar apotek hasil survei 2011 [List of community pharmacies surveyed in 2011]. Surabaya: Universitas Airlangga; 2011.Google Scholar
  21. 21.
    American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care. 2013;36(Suppl 1):S11–66.PubMedCentralCrossRefGoogle Scholar
  22. 22.
    Perkumpulan Endokrinologi Indonesia (PERKENI). Konsensus pengendalian dan pencegahan diabetes mellitus tipe 2 di Indonesia 2011 [The 2011 consensus for the management and prevention of type 2 diabetes mellitus in Indonesia] [Internet]. Jakarta: PERKENI; 2011 [cited 9 Jan 2015].
  23. 23.
    Power A, Douglas E, Mc Gregor A, Hudson S. Professional development of pharmaceutical care in type 2 diabetes mellitus: a multidisciplinary conceptual model. Int J Pharm Pract. 2006;14(4):289–99.CrossRefGoogle Scholar
  24. 24.
    Diabetes Australia. Diabetes management in general practice: guidelines for type 2 diabetes 2012/13. Canberra: diabetes Australia Limited; 2012. ISBN: 978 1875690 190.Google Scholar
  25. 25.
    Landis J, Koch G. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMedGoogle Scholar
  26. 26.
    Nugroho M. Analisis pengelompokan dan pemetaan kecamatan sebagai dasar program untuk mengatasi masalah-masalah sosial-ekonomi di Kota Surabaya [Analysis of distric mapping systemto manage socio-economic issues in Surabaya] [dissertation]. Surabaya: Institut Sepuluh Nopember; 2010.Google Scholar
  27. 27.
    Ikatan Apoteker Indonesia (IAI)—cabang Surabaya. Daftar apoteker Surabaya 2006–2011 [List of pharmacists in Surabaya 2006–2011]. Surabaya: IAI; 2011.Google Scholar
  28. 28.
    Timmer J, de Smet P, Schuling J, Tromp TJD, den Berg L. Patient education to users of oral hypoglycaemic agents: the perspective of Dutch community pharmacists. Pharm World Sci. 1999;21(5):200–4.CrossRefPubMedGoogle Scholar
  29. 29.
    Stewart K, O’Shea J, McCaig D. Agreement of practitioners with the recommendations of the ‘Guidelines for community pharmacists on the care of patients with diabetes’. J Soc Admin Pharm. 2003;20(1):13–7.Google Scholar
  30. 30.
    Herqutanto. Wahai dokter Indonesia, berkomunikasilah [Indonesian doctors, please communicate]. Maj Kedokt Indones. 2009; 59:35–38.Google Scholar
  31. 31.
    Berbatis C, Sunderland B, Mills C, Bulsara M. National pharmacy database project. Perth: Curtin Unversity; 2003. ISBN: 1-74067-2747.Google Scholar
  32. 32.
    Pemerintah Republik Indonesia. Peta jalan menuju Jaminan Kesehatan Nasional 2012–2019 [A road map to the National Health Insurance 2012–2019] [Internet]. Jakarta: Pemerintah Republik Indonesia; 2012 [cited 10 Feb 2015]. ISBN: 978-602-18863-0-4.
  33. 33.
    Pemerintah Republik Indonesia. Undang-Undang Republik Indonesia nomor 40 tahun 2004: Sistem Jaminan Sosial Nasional [Republic of Indonesia Law number 40 of 2004: National Social Insurance System]. Jakarta: Sekretariat Negara Republik Indonesia; 2004.Google Scholar
  34. 34.
    McDonough R, Doucette W. Developing collaborative working relationships between pharmacists and physicians. J Am Pharm Assoc. 2001;41(5):682–92.Google Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Yosi Wibowo
    • 1
    • 2
    Email author
  • Richard Parsons
    • 1
  • Bruce Sunderland
    • 1
  • Jeffery Hughes
    • 1
  1. 1.Faculty of Health Sciences, School of PharmacyCurtin UniversityPerthAustralia
  2. 2.Faculty of Pharmacy, Centre for Medicines Information and Pharmaceutical CareSurabaya UniversitySurabayaIndonesia

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