Development of Quality Indicators of Dispensing Process for Hospital Pharmacists in Rheumatoid Arthritis Patients

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Ratchanok Boondee
Pattarin Kittiboonyakun
Siraphop Suwannaroj
Phayom Sookaneknun


Introduction: The process of dispensing including prescription reviews and drugs counseling provided by pharmacist could prevent and reduce drug-related problem (DRPs). For increasing the quality of this process, the aim of this study   was to develop quality indicators (QIs) of  dispensing process of medications used in patients with rheumatoid arthritis (RA). Material and Method: Delphi technique with questionnaire was used, and were sent to experts 4 times. 28 experts were 4 rheumatologists, 6 medicines and 18 clinical pharmacists from 15 hospitals and 2 pharmacy lecturers. The 1st round questionnaire consisted of the indicators developed based on previous research and drug utilization pattern in RA patients, and open-ended questions for experts to give comment.The feedback and comment from the 1st round were generated to the 2nd round questionnaire containing a 5-point Likert scale to consider the rational and practical use of the indicators. The 3nd and 4th round questionnaires contained the same indicators as the 2nd round and were presented the results of individual answers in Median and Interqualtile range. A Consensus criteria was  the median value of  > 3.5 and Interquartile range (IQR) < 1 of each indicators for the 4th round. Results:  24 consensus committee responded (85.71%)  to the questionnaires. The final draft of quality indicators contained 12 items including the prescribing review (6 items) and counselling process (6 items). The indicators help to reduce and prevent DRPs of Diseases Modifying Rheumatic Drugs (DMARDs), Non-Steroidals Anti-inflammatory Drugs (NSAIDs) and steroids. Conclusion:  The study develops the practical quality indicators for RA patients. These indicators could facilitate the improvement of prescribing review and couseling process, potentially resulting in reducing and preventing DRPs. The study investigating the practical use of these indicators (reduced DRPs and improved clinical outcomes) in RA patients needs to be further conducted.


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Pharmaceutical Practice


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