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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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American college of rheumatology. Practice management. [Online]. 2011 [Cited 3 August 2011] Available from: http://www.rheumatology.Org/practice/clinical/patients/medications/index. Asp
American College of Rheumatology Subcommittee on Rheumatoid Arthritis. Guidelines for the management of rheumatoid arthritis 2002 update. Arthritis Rheum. 2002; 46: 328-46.
Arkaravichien W. Clinical Pharmacy. 2nd ed. Khonkean: Khonkean Printing; 1998.Charles F, Lora L, Morton P, Leonard L. Drug Information Handbook. 17th ed. Ohio; 2008-2009.
Chopra A. Epidemiology of rheumatic musculoskeletal disorders in the developing world. Best practice & Research Clinical Rheumatology. 2008; 22(4): 583-604.
Corbacho MI, Dapueto JJ. Assessing the functional status and quality of life of patients with rheumatoid arthritis. Bras J Reumatol. 2010;50(1):31-43. [Abstract]
Donabedian A. Evaluating the quality of medical care. The Milbank Quarterly (reprinted from The Milbank Memorial Fund Quarterly, Vol 44, No. 3, Pt 2, 1966, pp. 166-203). 2005; 83(4): 691-729.
Gourlay M, Franceschini N, Sheyn Y. Prevention and treatment strategies for glucocorticoid-induced osteoporotic fractures. Clin Rheumatol. 2007; 26: 144-153.
Harrold LR, Andrade SE. Medication Adherence of patients with selected rheumatic conditions: A systematic review of the literature. Semin Arthritis Rheum. 2009; 38: 396-402.
Khanna D, Arnold EL, Penzcharz JN, et al. Measuring Process of Arthritis Care: The Arthritis Foundation’s Quality Indicator Set for Rheumatoid Arthritis. Seminars in Arthritis and Rheumatism. 2006; 35:211-237.
Kittiboonyakun P. Recommendations for the improvement of pharmaceutical care services in patients with chronic non-cancer pain: using the root cause analysis framework. (thesis) UK: University of Aberdeen; 2010. 432 page.
Leecharoen S, Wangkaew S, Louthrenoo W. Ocular side effect of Chloroquine in patients with rheumatoid arthritis, systemic lupus erythematosus and scleroderma. J Med Assoc Thai. 2007; 52-57.
Maclean HC, Saag GK, Solomon HD, et al. Measuring Quality in Arthritis Care: Methods for Developing the Arthritis Foundation’s Quality Indicator Set. Ann Rheum Dis. 2010; 69: 964-975.
Macmillan TT. The Delphi technique. In: Paper presented at the Annual Meeting of the California Junior Colleges Association Commission on Research and Development, California Junior Colleges Association Com-mission, Monterey, CA, 1978 May 3, pp. 1-5.
Majithia V, Geraci S. Rheumatoid Arthritis: Diagnosis and Management. The American Journal of Medicine. 2007; 120: 936-939.
Montakantikul P. Roles of pharmacists for pharmaceutical care in outpatient department. In: Jindavijuk B, editors. New step of pharmaceutical care in out patient department. Bangkok: The Association of Hospital Pharmacist(Thailand); 2003. P. 2-11.
National Institute for Health and Clinical Excellence 2009(NICE). Rheumatoid arthritis The management of Rheumatois Arthritis in adults. Available from: URL: http://www.nice.org.uk/nicemedia/pdf/CG79NICEGuideline.pdf
Nilganuwong S, Preechanoon S, editors. Textbook of Arthritis. 2nd ed. Bangkok: Thai Rheumatism Association; 2005.
Sheen SS, Choi EJ, Park WR, et al. Overdose rates of drug requiring renal dose adjustment: Data analysis of 4 years prescribings at a tertiary teaching hospital. J Gen Intern Med. 2007; 23(4): 423-8.
Sirikhedgon U. The Study of adverse drug events in rheumatoid arthritis outpatients at Ramathibodi hospital. (Thesis). Bangkok: Mahidol University; 2007. 199 page.
Smolen J, Landewe R, Breedveld F, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010; 69:964-975.
Smolen J, Aletaha AD, Bijlsma JW, et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis. 2010; 69: 631-637.
Tatro D. Drug Interaction Facts, The authority on drug interactions. Walters Kluwer Health. 2011.Thai Rheumatism Association. Clinical Practice Guideline [Online]. 2009 Jul 7 [cited 2010 Nov 11]. Available from: http://www.thairheu-matology.org/download/Rheumatoid_Arthri-tis_070709.pdf
Van Roon EN, van den Bemt PM, Jansen TL, Hout-man NM, van de Laar MA, Brouwers JR. An Evidence-Based Assessment of the Clinical Signifi cance of Drug-Drug Interactions Between Disease-Modifying Antirheumatic Drugs and Non-Antirheumatic drugs According to Rheumatologists and Pharmasists. Clinical Therapeutics. 2009; 31(8): 1737-1746.