A survey of Indonesian citizens’ perspectives on the role of the pharmacist in managing side-effects

Abstract Introduction In Indonesia, Ministry of Health regulations encourage pharmacists’ engagement in managing and monitoring medication side-effects. However, the Indonesian national pharmacovigilance system only accepts adverse drug reaction (ADR) reports from hospital-based healthcare professionals and drug manufacturers.1 Considering the mixed expectations of pharmacists as ADR reporters depending on their sector of work and their availability as a patient-facing healthcare professional (HCP), it is vital to explore how their role is perceived by members of the public in Indonesia. Aim This study aimed to explore public perspectives on the role of pharmacists as one of the HCPs involved in monitoring and managing side effects in Indonesia. Methods Following Ethics committee approval from the UK and Indonesian institutions, a piloted questionnaire was distributed to eligible participants in six study settings (three hospitals and three community pharmacies) in Indonesia. Participant inclusion criteria were: Indonesian residents aged 18 or over who had direct experience of, or cared for someone who experienced, a side-effect. Appointed pharmacist gatekeepers at the study sites displayed posters advertising the study and distributed paper questionnaires to eligible participants. Recruitment posters also included a QR code which participants could directly use to access the questionnaire online. Data were collected over eight weeks at each study site between March to June 2025. Data were entered into an Excel spreadsheet and analysed using frequency tables. Results A total of 265 participants returned a questionnaire (paper = 263; online = 2); 160 participants had a personal experience while 105 were the carer of someone with an ADR. Of the 271 medications involved in the reported side-effects, the majority were to prescribed medication (142; 52.40%) and over the counter (OTC) medication (109; 40.22%). From all participants, 128 respondents (48.30%) had shared their experience: 103 (80.47%) had formally reported the side-effect to a healthcare professional (prescribed medicine: 73; OTC medicine: 27; other: 3). Participants most commonly reported side-effects to doctors (74; 71.84%); only a few of them (16; 15.53%) reported to pharmacists. Notably, participants also preferentially reported OTC medicine side-effects to doctors (14; 51.85%) compared to pharmacists (8; 29.63%). However, half the participants (49.86%) expected pharmacists to provide side-effect information compared to doctors (34.78%). Participants indicated that healthcare professionals should be proactive in the management of side-effects by: prescribing/supplying appropriate medication (255; 97.70%), providing information on common side-effects (253; 96.93%), recommending treatment for side-effects (235; 90.73%), and promoting side-effects to members of the public (252; 97.30%). Conclusion This study suggests that, despite societal expectations that pharmacists should provide side-effect information, patients do not generally report side-effects to them. Given OTC medicines accounted for 40% of side-effects experienced by participants, community pharmacists can have a pivotal role. Overcoming this missed opportunity by permitting community pharmacists to report ADRs to the national pharmacovigilance system is important for patient safety. This study captured the life-experience of many citizens; however, participants were self-selecting and their views may not represent those of non-responders. Further work is needed to explore pharmacists’ perspectives on ADR monitoring and improvements to the national pharmacovigilance system to promote reporting.