Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Cross-Sectional Study on Knowledge, Attitude and

Practice of Pharmacist at Community Pharmacy in
Indonesia about COVID-19
Yelly Oktavia Sari, Dedy Almasdy, Dini Rizki Amalia
Faculty of Pharmacy, Andalas University Padang,
West Sumatera, Indonesia

Abstract:- COVID-19, which first occurred in Wuhan, Pharmacists are an important part of the healthcare
China, has spread rapidly to almost all countries including system, and their role is critical in perfecting the COVID-19
Indonesia and was announced by the WHO as a pandemic. outbreak management cycle (6). Pharmacists at community
The Indonesian government establishes a “Task Force pharmacy provide patient-oriented pharmaceutical care and
Acceleration of Handling COVID-19” for handling practice in drug stores (7). Patient-oriented pharmaceutical
COVID-19. Pharmacists are an important part of the care in community pharmacy during the COVID-19 period
health care system and play a role in perfecting the must pay attention to the sanitation of dispensing room and
COVID-19 outbreak management cycle. Pharmacists play personal protection of personnel in customer service, and it is
a role in ensuring the continued functioning of the health necessary to provide education on preventing COVID-19
care system in the detection, prevention and management transmission to customers(8).
of cases. In this practice, pharmacists need knowledge,
attitudes and practices related to COVID-19. This study In their practice, pharmacists in community pharmacy
aims to evaluate knowledge, attitudes and practices of have very big possibilities for contracting this pandemic. As
pharmacists in Community Pharmacy in Indonesia about pharmacists in community pharmacy have direct contact with
COVID-19, and examines the relationship between these patients during this crisis, understanding their knowledge,
three variables. This research is a cross-sectional study, attitudes and practices towards COVID-19 is important to
and the sampling technique is purposive sampling. The classifying misconceptions about COVID-19 treatment and to
study instrument was a validated questionnaire that was contribute of COVID-19 screening.
distributed through social media (WhatsApp).
178pharmacist was qualified to participate in this study. This research to evaluated of the level of knowledge,
The results of the study showed that pharmacists have a attitude and practice of pharmacist at community pharmacy in
high level of knowledge (83.1%), positive attitude (54.5%) Indonesia about COVID-19.
and good practices (57.3%) about COVID-19. In this II. RESEARCH METHOD
study, knowledge level of pharmacists was influenced by
the education level, attitudes was influenced by the This research is an observational study with a cross-
education level and the province’s recovery rate, while sectional study design. This research was conducted on
practice was influenced by gender. Statistical analysis pharmacists who served in drug stores/ community pharmacy
between knowledge, attitude and practice of pharmacists spread across several provinces in Indonesia during the past
about COVID-19 showed that there was a significant few months (± 6 months) in December 2020 to May 2021.
relationship between knowledge with attitude and attitude The instrument used in this study was a questionnaire
with practice and knowledge with practice (p<0.05). designed on Google forms platform®. The questionnaire was
developed largely based on the World Health Organization
Keywords:- COVID-19, Knowledge, Attitude, Practice, (WHO) Questions and Answers on COVID-19 and from
Community Pharmacy. several existing research that was adapted to the
I. INTRODUCTION pharmaceutical study. Respondents in this study were selected
by purposive sampling method according to the inclusion
The mysterious pneumonia cases that was first reported criteria and exclusion criteria set by the researcher. The
in Wuhan, China's Hubei Province in December 2019 has content validity test was carried out by experts, namely five
spread widely to various other provinces in China and several pharmacists and one linguist. The validity and reliability
other countries in a short time (1). This virus is named SARS- testing was then carried out on 30 people according to the
COV-2 and the disease caused by this virus is named COVID- general rules of research in order to obtain a distribution of
19 (2). On March 11, 2020, WHO declared COVID-19 a research results that approached the normal curve (9).
pandemic (3). The first case in Indonesia was detected and
announced on March 2, 2020 by President Jokowi (4). The The data collection method was carried out by
number of incidents in Indonesia continues to increase with a distributing online questionnaires through social media
morbidity rate of 8.7% which is the highest rate in Southeast (WhatsApp) by providing a link that was connected to the
Asia and much higher than China (4%) (5). questionnaire to be filled out by the respondents. The
questionnaire contains 47 questions including: socio-
demographic data (10 questions), knowledge level evaluation
(17 questions), attitude (8 questions) and practice (12

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Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
questions) in pharmaceutical care and practices about COVID- the most age in the range <35 years as many as 93 respondents
19. After the data collected, then its tabulated and coded. The (52.2%) who are married as many as 146 respondents (82.0%)
data then processed using the SPSS program version 16. The with education level an average of 154 are a pharmacists
relationship of respondents' demographic characteristics with (86.5%) and experienced as a pharmacist ≤ 10 years as many
the knowledge level, attitudes and practices was determined as 117 respondents (65.7%) who generally work in provinces
using Chi Square. While Spearman’s correlation is used to with a moderate recovery rate of COVID-19 as many as 129
determine the relationship between these three variable that is respondents (72.5%).
relationship knowledge with attitude, attitude with practice
and knowledge with practice of pharmacist in Community Most of the respondents obtained information about
Pharmacy about COVID-19. COVID-19 from social media (36.2%) and television (31.3%).
Pharmacists need to have the right information about COVID-
III. RESULT AND DISCUSSION 19 and convey that knowledge to the public. The use of
accurate information media tools is one of the basic
The respondents who met the inclusion criteria was 178 requirements to prevent and control the spread of disease (10).
respondents. From the socio-demographic data, respondents The type of information most needed by respondents was
were categorized by gender, age, education level, marital about infection prevention and control (36.5%). This supports
status, experience and the division of provinces based on the the research results that the level of pharmacist participation in
recovery rate. Based on the results listed in table 1, out of 178 offline or online training is very low.
respondents it is known that most of the respondents are
female pharmacists as many as 127 respondents (71.3%) with

n = 178
No Characteristics of Respondents
F %
1 Gender
Man 51 28.7
Woman 127 71.3
2 Age
< 35 years old 93 52.2
≥ 35 years old 85 47.8
3 Marital status
Not Married 32 18.0
Married 146 82.0
4 Education level
Pharmacist 154 86.5
Pharmacist with additional education(master/doctor) 24 13.5
5 Experience
≤10 years 117 65.7
> 10 years 61 34.3
6 Provincial Division
Province with high recovery rate 29 16.3
Province with moderate recovery rate 129 72.5
Provinces with low recovery rate 20 11.2
7 Resources
Television 142 31.3
Social media 164 36.2
Health workers 71 15.7
Scientific journals 63 13.9
Other 13 2.9
8 More information needed
Pathology 86 19.4
Infection Prevention and Control 162 36.5
Diagnosis 57 12.8
Treatment 131 29.5
Other 8 1.8

Table 1: Distribution of pharmacists' socio-demographic characteristics in community pharmacy in Indonesia

The results of data collection using a questionnaire about the level of knowledge of pharmacists at Community Pharmacy in
Indonesia about COVID-19 can be seen in table 2.

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Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Question True Frequency (%)
Fever, fatigue, convulsions and dry cough are the main symptoms of COVID- 54 (30.3)
19
The incubation period (from exposure to the first appearance of symptoms) of 75 (42.1)
COVID-19 is 2-5 days
The virus that causes COVID-19 can spread through respiratory droplets 83 (46.6)
when a patient coughs/sneezes even though they are more than two meters
away
There is no difference in the risk of potential exposure to pharmacists who 86 (48.3)
work in services with pharmacists who work in non-services.
The first case of COVID-19 was discovered in Hainan, China. 87 (48.9)
Azithromycin/levofloxacin given to COVID-19 patients to kill the SARS-2 87 (48.9)
corona virus
Mixing bleach and household cleaning to get the maximum disinfectant is the 90 (50.6)
right thing to do.
Individuals aged < 60 years and do not have health problems may use non- 113 (63.5)
medical masks
WHO prohibits the use of dexamethasone in non-severe COVID-19 patients, 145 (81.5)
unless the patient has received other therapy
Vitamin D in COVID-19 therapy is needed by people who are not exposed to 148 (83.1)
sunlight (isolation)
All patients who are positive for COVID-19 have symptoms 149 (83.7)
To reduce the transmission of COVID-19, disinfection of environmental
surfaces can use Na. Hypochlorite (eg: Bayclin) 0.1%. 153 (86.0)
Use chloroquine for COVID is not recommended because it can cause heart 153 (86.0)
rhythm disturbances
Always and regularly wash your hands with soap or Hand sanitizer can
reduce the spread of the COVID-19 virus. 166 (93.3)
Avoiding touching your eyes, nose and mouth when serving patients can
prevent COVID-19 infection. 166 (93.3)
COVID-19 is a disease caused by the SARS 2 Corona virus (SARS-CoV-2). 169 (95.0)
Using a mask or face shield and the presence of a glass barrier when serving
173 (97.2)
patients who redeem drugs can reduce the spread of COVID-19
Table 2: Distribution of respondents based on knowledge questions

From the question of the level of knowledge of found in Nigeria at 91%(11) and higher than that found in
pharmacists, 95% of respondents know that COVID-19 is a Ethiopia and Egypt by 68% and 66.7% (12),(10).
disease caused by Corona virus SARS 2 (SARS-CoV-2). From
the achievement of the highest score, it can be understood that The lowest achievement was found in questions
almost all respondents know how to protect themselves from regarding the main symptoms of COVID-19, namely
transmission of COVID-19, by using a mask or face shield fever,tired and dry cough that is, only 30.4% of respondents
and the presence of a glass barrier when serving patients who who answered correctly were different from those who
redeem drugs (97.2%), avoiding touching the eyes, nose and answered correctly Found by Cacodcar about 61% (13), and
mouth when serving patients (93.3%), Always and regularly by Alzoubi about 68.4% (14). According to WHO the most
washing hands with soap and hand sanitizer (93.3%) can common symptoms today are fever, fatigue, cough, and loss of
reduce the spread of COVID-19. This is similar with that the ability to feel or smell (anosmia).

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Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Question f(%)
Strongly
disagree 0 (0)
Do not agree 1 (0.6)
Neutral 8 (4.5)
I am willing to explain to patients how to prepare disinfectant Agree 98 (55.0)
at home Strongly agree 71 (39.9)
Strongly
disagree 1 (0.6)
Do not agree 9 (5.0)
Neutral 30 (16.9)
I am willing to provide pharmaceutical services for patients Agree 65 (36.5)
with COVID-19 infection with complete PPE Strongly agree 73 (41.0)
Strongly
disagree 0 (0)
Do not agree 0 (0)
I feel uncomfortable when patients wait for drugs at the Neutral 19 (10.7)
Pharmacy/Pharmaceutical Installation without keeping a Agree 69 (38.8)
distance. Strongly agree 90 (50.6)
I am worried that when I serve patients there is no glass Strongly
barrier between me and the patient disagree 0 (0)
Do not agree 1 (0.6)
Neutral 15 (8.4)
Agree 68 (30.2)
Strongly agree 94 (52.8)
I am afraid that while working in pharmaceutical facilities I Strongly
do not use PPE (masks, face shields or gloves). disagree 0 (0)
Do not agree 0 (0)
Neutral 14 (7.9)
Agree 70 (39.3)
Strongly agree 94 (52.8)
Strongly
disagree 0 (0)
Do not agree 0 (0)
I feel the need to ensure the availability of pharmaceutical Neutral 13 (7.3)
supplies needed for handling COVID-19 Agree 58 (32.6)
Strongly agree 107 (60.1)
I'm worried if the patient who redeems the drug to the Strongly
pharmacy/pharmacy installation doesn't wear a mask disagree 0 (0)
Do not agree 0 (0)
Neutral 3 (1.7)
Agree 59 (33.1)
Strongly agree 116 (65.2)
Strongly
disagree 0 (0)
Do not agree 1 (0.6)
Neutral 3 (1.7)
If I am exposed to COVID-19, I will isolate according to the Agree 54 (30.3)
COVID-19 handling guidelines Strongly agree 120 (67.4)
Table 3: Distribution of respondents based on attitude questions

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Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Judging from the level of achievement of the respondents respondents believed that using a mask could reduce the
in each of their statements of attitude about COVID-19, it was spread of the virus(14).
found that respondents have positive attitude about COVID-
19, it was found in their statements that responded to worry While the lowest achievement of respondents' attitudes
when patients who redeemed drugs at the Community can be seen from their statements about their willingness to
Pharmacy/drug stores did not wear masks, that achievement of explain to patients about how to prepare disinfectants at home,
respondents' attitudes reached 65.2%. This is supported by where in this statement only 39.9% agreed. This is supported
research conducted by Zhang that 85% of health workers are by the level of knowledge of pharmacists who are still lacking
worried that they will be exposed to the COVID-19 virus in in how to prepare disinfectants at home and that mixing bleach
the workplace(15). In addition, in a study in Jordan, 68.4% of and household cleaning is wrong. This question was answered
correctly by only 50.6% of respondents.

Question f(%)
Did you participate in any training related to COVID-19 Always 35 (19.7)
during the pandemic (offline or online) Often 58 (32.6)
Seldom 54 (30.3)
Never 31 (17.4)
Are you educating the public regarding COVID-19. Always 49 (27.5)
Often 59 (33.1)
Seldom 57 (32.0)
Never 13 (7.3)
Do you limit the number of patients waiting for drugs at the Always 65 (36.5)
pharmacy/pharmacy?
Often 71 (39.9)
Seldom 30 16.9)
Never 12 (6.7)
Do you clean the surface area where the work area is with Always 91 (51.1)
disinfectant. Often 70 (39.3)
Seldom 16 (9.0)
Never 1 (0.6)
I remind patients who will enter the Pharmacy / Pharmacy Always 95 (53.4)
Installation to put on the correct mask
Often 60 (33.7)
Seldom 20 (11.2)
Never 3 (1.7)
Do you always keep your distance from people who come to Always 108 (60.7)
the pharmacy/pharmacy installation?
Often 62 (34.8)
Seldom 8 (4.5)
Never 0 (0)
Do you always use a mask, face shield or gloves at work? Always 117 (65.7)
Often 50 (28.1)
Seldom 10 (5.6)
Never 1 (0.6)
Do you wash your hands the right way? Always 119 (66.9)
Often 55 (30.9)
Seldom 4 (2,2)
Never 0 (0)
I make sure the hand washing facilities where I work are Always 120 (67.4)
functioning properly Often 47 (26.4)
Seldom 7 (3.9)
Never 4 (2,2)
Do you avoid touching your eyes, nose or mouth when Always 125 (70.2)
interacting with patients or customers? Often 46 (25.8)
Seldom 7 (3.9)

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Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Never 0 (0)
After work, do you follow the health protocol when you get Always 128 (71.9)
home (shower and change clothes)
Often 41 (23.0)
Seldom 9 (5.1)
Never 0 (0)
Do you ensure the availability of masks at your Always 145 (81.5)
pharmacy/pharmacy installation Often 31 (17.4)
Seldom 2 (1,1)
Never 0 (0)
Table 4: Distribution of respondents by practice questions

Judging from the level of achievement of respondents in pandemic (offline or online), which in this statement only
each statement about their practices on COVID-19, it was reached 19.7%. Followed by the practice of pharmacists in
found regarding their practice efforts against COVID-19 well educating the public about COVID-19, which only reached
found in their statements that ensure the availability of masks 27.5%.
(81.5%), follow health protocols when they get home (71.9%)
and always avoid touching their eyes, mouth and nose when The role of health workers who serve the community is
interacting with people. other people, and always implement very important in preventing and the handling of COVID-19 at
health protocols when they get home from work (70.2%). This every level of intervention. Medical personnel are considered
is also supported by the high achievement rate in respondents' more capable of understanding the promotive and preventive
knowledge that in addition to avoiding touching the eyes, patterns of COVID-19 in the community. In fact, health
mouth and nose, the implementation of health protocols can workers who serve the community, including officers at
also reduce the spread of this virus. Almost the same as that pharmacies who are at the forefront of handling COVID-19,
obtained by Saqlain that pharmacists avoid touching the eyes, are the group most vulnerable to contracting the SARS-CoV-2
nose, and mouth by 74.6%(16). In contrast to research in Saudi corona virus.
Arabia which describes that 90.38% of respondents do not
avoid touching their eyes, mouth and nose because they are Table 5 shows that pharmacists with additional education
not related to the spread of the virus(17). Regarding the (master/doctor) have higher knowledge about COVID-19
implementation of the health protocol when coming home (p<0.05). This provides a significant relationship to the level
from work, Saefi found that only 60.38% of respondents of pharmacist knowledge about COVID-19. This is similar to
carried out the health protocol (changed clothes) when they that found in Pakistan and Bangladesh that the level of
came home from work before interacting with other family education is significantly related to the level of knowledge
members(18). Similar to what was found in Bangladesh that about COVID-19(21)(19).
98.6% of respondents always follow health protocols when The table also shows that the attitude of respondents in
they return home(19) dealing with COVID-19 was significantly higher (P<0.05) for
In carrying out their role as pharmacists who are pharmacists with additional education (master/doctor). The
responsible for pharmaceutical supplies, especially masks, province's recovery rate also had a significant effect on
81.5% of respondents carry out this role. From the research pharmacists attitude, it was seen that 70% had a negative
reported from Jordan that one of the reported roles of attitude in provinces with low recovery rates (P<0.05). This
pharmacists during a pandemic is ensuring adequate storage shows that the recovery rate of a region also affects the
and supply of drugs and medical devices in addition to the role attitude of pharmacists.
in disease prevention and infection control as well as a role in The practices of pharmacists on COVID-19, both in
patient care and support for other health professionals(20). carrying out pharmaceutical practices and in their roles as
This supports the achievement on the question of pharmacist pharmacists, shows that practice of female pharmacists have
practice who always ensures the availability of masks in good practices than men (P<0.05). Research conducted in
pharmacy/pharmacy facilities, which is 81.5%. Pakistan and Bangladesh, also found that female respondents
While the lowest achievement of respondents' practices have good practices in terms of preventing exposure to
can be seen from their statements about the lack of COVID-19 (that women are more likely to maintain a safe
participation in training related to COVID-19 during the distance than men).

IV. RELATIONSHIP BETWEEN VARIABLES

Variable Correlation Coefficient P Value

Knowledge – Practice 0.218 0.003*
Attitude – Practice 0.238 0.001*
Knowledge – Attitude 0.252 0.001*
Table 5: Correlation Score

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Volume 7, Issue 5, May – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Correlation between the knowledge level with attitudes, RESEARCH LIMITATIONS
attitudes with practices and knowledge level with practices, it
appears that there is a significant correlation between these Data on the number of pharmacists at Community
three variables. In theory it is said that behavioral change Pharmacy in Indonesia cannot be accessed, so to determine the
requires three stages, namely changing the knowledge level in number of samples only with the minimum number of samples
this case about COVID-19(cause, symptoms, how to treat, that must be met is determined. The number of samples is
how to transmit, how to prevent, how to maintain health and limited because this research data is only based on the number
how to live healthy and how to manage environmental health). of returned questionnaires due to limited communication with
After someone knows the stimulus or object, the next process pharmacists in the target provinces.
will assess or behave towards the stimulus or object which will
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