The role of pharmacists in community education to promote responsible self-medication in Indonesia: an application of the spiral educational model.

Background Community empowerment is one key strategy to improve the health of Indonesians. In 2015, the Government initiated the 'Smart Use of Medications Campaign' to empower Indonesians to practice responsible self-medication. Analysis of a pilot training program established in 2016 identified that improvements were needed in the content and organisation of the module. Objective To evaluate a revised module (applying a spiral model approach) to guide community training as part of the 'Smart Use of Medications Campaign'. Setting The Ngawi District, Indonesia in May 2018. Method Eight pharmacists (trainers) and 39 community representatives (participants) were involved in the training based on the revised module. The module adopted the spiral approach and consisted of three progressive steps: (1) understanding basic concepts of information on the label/package of one medication product; (2) re-enforcing that concept to understand medication classification (applied using three products); and (3) expanding the concept to understand medication classification (applied using a pack of 40 products). Pre-/post-test scores were used, and Focus Group Discussions were conducted to explore the participants' knowledge gain. Main outcome measure: participants' and trainers' views on the spiral process. Result Participants' mean overall knowledge gain increased from 12.53/15 to 13.44/15 (p = 0.001). Six focus groups of participants and two focus groups of trainers perceived that both trainers and participants found the spiral model better facilitated understanding, as it involved step-by-step learning. They also indicated the importance of the role of pharmacists as suitably qualified trainers as well as the development of appropriate training aids/media and arrangements. Conclusion Training based on the spiral model has the potential to be implemented in community training to improve self-medication literacy among the Indonesian public. Support from pharmacists as well as the relevant national and professional bodies is essential for successful implementation of the training.