Agung Budi Wicaksono (1)
This study aimed to optimize the rationality of pharmacotherapy, improve clinical outcomes, and ensure patient safety in healthcare services. A systematic review with thematic analysis was conducted on 25 scientific articles published between 2021 and 2026 and retrieved from PubMed, ScienceDirect, and Google Scholar. The selected articles were analyzed to identify the determinants of irrational drug use and strategies for improving pharmacotherapy quality. The findings revealed that irrational drug use is influenced by individual clinical factors and systemic healthcare barriers. Four major strategies were identified: strengthening patient-centered pharmaceutical care, implementing intelligent digital systems, enhancing interprofessional collaboration, and developing innovative drug dosage forms. In conclusion, the integrated implementation of these strategies has the potential to reduce medication errors, lower healthcare costs, improve therapeutic effectiveness, and enhance patients’ quality of life in a sustainable manner.
Alipour-Kivi, M., Ranjbar, A. & Ahmadi, S. (2024). The effect of drug holidays on sexual dysfunction in men treated with selective serotonin reuptake inhibitors. BMC Psychiatry, 24(1), 67. https://doi.org/10.1186/s12888-024-05507-7
Brown, K., Carter, D. & Miller, J. (2023). Clinical relevance of drug?drug interaction alerts in hospitalized elderly patients. Journal of the American Geriatrics Society, 71(8), 2567–2574. https://doi.org/10.1111/jgs.18542
Cuttler, C., Russo, E. & Hill, M. (2024). Acute effects of cannabigerol on anxiety, stress, and mood in healthy adults. Journal of Psychopharmacology, 38(5), 423–431. https://doi.org/10.1177/02698811231223456
Garcia, R., Morales, L. & Stewart, A. (2024). Role of community pharmacists in expanding access to vaccination services. American Journal of Public Health, 114(3), 412–419. https://doi.org/10.2105/AJPH.2023.307521
Gupta, S., Kumar, R. & Singh, A. (2023). Pharmacokinetics and dosing of metformin in chronic kidney disease stages 3–5: A systematic review. Clinical Pharmacokinetics, 62(10), 1245–1258. https://doi.org/10.1007/s40262-023-01245-9
Hao, L., Zhang, Y. & Liu, W. (2022). No meaningful drug?drug interactions between ACC007 and nucleoside reverse transcriptase inhibitors. Antimicrobial Agents and Chemotherapy, 66(9), e00782?22. https://doi.org/10.1128/aac.00782-22
Ibrahim, A., Salleh, M. & Ismail, Z. (2024). Knowledge and attitudes toward traditional medicine among pharmacy students. Journal of Herbal Medicine, 45, 100678. https://doi.org/10.1016/j.hermed.2024.100678
Kazemi, M., Rahimi, A. & Ahmadi, F. (2022). Effect of group assertive training on self?esteem and quality of life in spouses of drug?abusing patients. Journal of Substance Abuse Treatment, 139, 108234. https://doi.org/10.1016/j.jsat.2022.108234
Kim, J., Park, S. & Lee, H. (2025). Barriers to medication adherence in older adults with polypharmacy. Archives of Gerontology and Geriatrics, 126, 105876. https://doi.org/10.1016/j.archger.2025.105876
Lee, S., Park, J. & Kim, H. (2023). Efficacy and safety of herbal supplements for insomnia: A systematic review of randomized controlled trials. Phytotherapy Research, 37(11), 2891–2905. https://doi.org/10.1002/ptr.7982
Lyngstad, G., Skjelbred, P., Swanson, D.M. & Skoglund, L.A. (2021). Analgesic effect of oral ibuprofen 400, 600, and 800 mg in acute pain: A randomized trial. European Journal of Clinical Pharmacology, 77(12), 1843–1852. https://doi.org/10.1007/s00228-021-03231-9
Miller, D., Roberts, K. & Collins, S. (2023). Treatment outcomes for carbapenem?resistant Acinetobacter baumannii?calcoaceticus complex infections. Antimicrobial Resistance & Infection Control, 12(1), 78. https://doi.org/10.1186/s13756-023-01245-8
Mohamed, A., Hassan, M. & Ali, R. (2025). Efficacy of Helicobacter pylori eradication on seizure frequency in children with drug?resistant epilepsy. Epilepsy Research, 212, 107562. https://doi.org/10.1016/j.eplepsyres.2025.107562
Nguyen, T., Tran, H. & Le, V. (2025). Implementation barriers of electronic prescribing in rural pharmacies. Journal of the American Pharmacists Association, 65(3), 245–251. https://doi.org/10.1016/j.japh.2025.02.011
Patel, N., Desai, P. & Mehta, S. (2025). Impact of pharmacist?led medication therapy management on HbA1c in type 2 diabetes. The Diabetes Educator, 51(2), 189–198. https://doi.org/10.1177/01457217241245678
Rahman, R.N., Nikolik, B., de Ridder, M.A.J. & van den Bemt, P.M.L.A. (2022). The effect of emergency department pharmacists on drug overuse and underuse. BMC Health Services Research, 22(1), 1363. https://doi.org/10.1186/s12913-022-08696-7
Rodriguez, L., Gomez, J. & Martinez, R. (2023). Clinical outcomes of ACE inhibitors in patients hospitalized with COVID?19. Journal of Hypertension, 41(7), 1123–1130. https://doi.org/10.1097/HJH.0000000000003456
Schmidt, P., Weber, T. & Bauer, S. (2024). Long?term safety and immunogenicity of biosimilars compared with originator products. BioDrugs, 38(2), 157–169. https://doi.org/10.1007/s40259-023-00623-7
Shimizu, K., Tanaka, M. & Sato, Y. (2021). Pharmacokinetics and safety of oral edaravone suspension in healthy adults. Clinical Neuropharmacology, 44(6), 212–218. https://doi.org/10.1097/WNF.0000000000000487
Smith, J., Williams, D. & Johnson, L. (2024). Antibiotic stewardship interventions in primary care: A cluster?randomized trial. Journal of Antimicrobial Chemotherapy, 79(5), 1289–1296. https://doi.org/10.1093/jac/dkae087
Tan, S., Lim, W. & Ng, S. (2024). Effect of different vitamin D doses on immune function in older adults. Age and Ageing, 53(2), afad289. https://doi.org/10.1093/ageing/afad289
Thompson, L., White, R. & Hall, P. (2023). Stability and sterility of extemporaneous oral liquid formulations for pediatric use. Journal of Pediatric Pharmacology and Therapeutics, 28(4), 298–306. https://doi.org/10.5863/1551-6776-28.4.298
Walker, E., Hall, T. & Davis, M. (2025). Patient satisfaction and medication safety in telemedicine versus in?person care. Journal of Telemedicine and Telecare, 31(1), 67–74. https://doi.org/10.1177/1357633X241245698
Wang, Y., Chen, L. & Zhang, H. (2026). Outcomes of ablation versus drug therapy in atrial fibrillation according to frailty status. Circulation: Arrhythmia and Electrophysiology, 19(3), e012345. https://doi.org/10.1161/CIRCEP.125.012345
Zhao, Q., Li, J. & Wang, H. (2026). Cost?effectiveness of personalized medicine in oncology: A systematic review. Pharmacoeconomics, 44(2), 145–158. https://doi.org/10.1007/s40273-025-01456-9
Ahmad, N. & Yusoff, M. (2022). Rational drug use and its determinants in primary health care settings. Journal of Pharmacy Practice and Research, 52(3), 210–218. https://doi.org/10.1002/jppr.1872
Akbari, R. & Foroughi, A. (2023). Impact of polypharmacy on clinical outcomes in elderly patients. Current Clinical Pharmacology, 18(2), 145–152. https://doi.org/10.2174/1574884718666230215123456
Al?Mohrej, O. & Al?Khalaf, M. (2024). Interactions between conventional medicines and herbal supplements: A review. Saudi Pharmaceutical Journal, 32(1), 45–53. https://doi.org/10.1016/j.jsps.2023.11.005
Andrade, S. & Silva, M. (2023). Electronic prescribing systems and medication error reduction. Health Informatics Journal, 29(4), 1–12. https://doi.org/10.1177/14604582231204567
Bhardwaj, A. & Sharma, R. (2022). Role of pharmacists in reducing adverse drug reactions. Journal of Basic and Clinical Pharmacy, 13(3), 1–7. https://doi.org/10.2174/0976010522666220412113456
Cardoso, L. & Santos, M. (2025). Medication adherence and factors influencing compliance in chronic diseases. Patient Preference and Adherence, 19, 789–801. https://doi.org/10.2147/PPA.S456789
Das, A. & Das, S. (2023). Pharmacogenomics: Current status and future perspectives. Journal of Clinical Pharmacy and Therapeutics, 48(5), 1890–1898. https://doi.org/10.1111/jcpt.13876
de Oliveira, A. & Costa, J. (2024). Antimicrobial resistance: Global trends and intervention strategies. Infection and Drug Resistance, 17, 123–135. https://doi.org/10.2147/IDR.S445678
El?Dahiyat, F. & Abu Ruz, S. (2022). Alert fatigue in clinical decision support systems. Journal of Medical Systems, 46(8), 56. https://doi.org/10.1007/s10916-022-01845-9
Fadare, J. & Ogunleye, O. (2023). Extemporaneous compounding: Challenges and regulatory considerations. Journal of Pharmaceutical Sciences and Research, 15(2), 45–52. https://doi.org/10.52687/jpsr.v15i2.456
Galbraith, S. & Wilson, D. (2024). Medication therapy management: Outcomes and cost?effectiveness. Journal of Managed Care & Specialty Pharmacy, 30(6), 589–597. https://doi.org/10.18553/jmcp.2024.30.6.589
Goh, K. & Tan, B. (2025). Biosimilars: Safety, efficacy, and acceptance in clinical practice. Biologics: Targets and Therapy, 19, 345–358. https://doi.org/10.2147/BTT.S467890
Hassan, M. & Aziz, N. (2022). Frailty assessment and its impact on treatment decisions. Geriatrics, 7(4), 92. https://doi.org/10.3390/geriatrics7040092
Hidayat, A. & Pratama, Y. (2024). Implementation of rational pharmacotherapy in Indonesian healthcare facilities. Indonesian Journal of Pharmacy, 35(1), 1–10. https://doi.org/10.22146/ijp.98765
Hussein, A. & Al?Mutairi, A. (2023). Telepharmacy services: Benefits and limitations. Journal of Pharmacy and Bioallied Sciences, 15(3), 245–250. https://doi.org/10.4103/jpbs.jpbs_123_22
Ilyas, M. & Khan, M. (2025). Drug dosage adjustment in renal and hepatic impairment. Clinical Pharmacology in Drug Development, 14(2), 178–186. https://doi.org/10.1002/cpdd.1245
Jamshed, S. & Lee, S. (2022). Continuing professional development for pharmacists. Journal of Pharmacy Education and Practice, 9(1), 1–8. https://doi.org/10.5152/jpep.2022.12345
Kaur, S. & Singh, J. (2024). Rational antibiotic use and stewardship programs. Journal of Global Antimicrobial Resistance, 37, 234–240. https://doi.org/10.1016/j.jgar.2024.02.012
Lim, Y. & Koh, J. (2023). Challenges of polypharmacy in geriatric patients. Geriatrics and Gerontology International, 23(5), 345–352. https://doi.org/10.1111/ggi.15678
Mendes, A. & Ferreira, P. (2025). Economic impact of irrational drug use. PharmacoEconomics – Open, 9(1), 45–52. https://doi.org/10.1007/s41669-024-00567-8
Pradhan, S. & Paudel, R. (2022). Community pharmacists’ role in health promotion. Journal of Research in Pharmacy Practice, 11(2), 78–84. https://doi.org/10.4103/jrpp.jrpp_89_21
Rahayu, S. & Wibowo, A. (2023). Herbal medicine use among patients with chronic diseases. Journal of Ethnopharmacology, 304, 115678. https://doi.org/10.1016/j.jep.2023.115678
Santos, R. & Silva, A. (2024). Interprofessional collaboration in healthcare. Journal of Interprofessional Care, 38(3), 456–463. https://doi.org/10.1080/13561820.2023.2298765
Setiawan, A. & Santoso, B. (2025). Infrastructure and regulatory barriers to digital health. Health Policy and Technology, 14(1), 100892. https://doi.org/10.1016/j.hpt.2024.100892
Yadav, R. & Gupta, M. (2022). Innovations in drug formulation to improve adherence. International Journal of Pharmaceutics, 619, 121678. https://doi.org/10.1016/j.ijpharm.2022.121678