Pharmaceutical care situation in community hospitals of Surin province

Abstract

Introduction: Pharmaceutical  care  has  been  developing  for  better patient  outcome.  This research  aimed to  survey  pharmaceutical  care  activities  in  community  hospitals  of  Surin  province. Methods: The  questionnaire  was  developed  based  on  standards of  the  Healthcare  Accreditation Institute, criteria of the National Health Security Office and the Ministry of Public Health and literature review. The questionnaire was evaluated for content validity by experts and it was tested in 10 pilot hospitals which  were not  the  study hospitals.  Then, the questionnaire  was sent  to  the head  of  the pharmacy department in 16 community hospitals, Surin province. Data were collected during October 2014  to  September  2015.  Descriptive  statistics  were used  for  data  analysis. Results: Input evaluation revealed that 11 hospitals (68.8%) had problem of manpower shortage. Proportion of time that pharmacists could spend on conducting pharmaceutical care was less than 20% of their working time.  Process  evaluation  found  that  pharmaceutical care  was  set  as  part  of  chronic  care  clinic, outpatient  services.  Pharmaceutical  care  for  diabetes  and  hypertension  were  available  in  all  16 hospitals while the services for asthma, chronic obstructive pulmonary disease, tuberculosis, human immunodeficiency  virus,  psychiatric  clinics  were  available  in  12  hospitals.  Pharmaceutical  care  for patients  receiving  warfarin  and  patients  with  chronic  kidney  disease  were  available  in  7  and  8 hospitals. For in-patient services, 9 hospitals (56.3%) had pharmacists responsible for daily services by which medication  reconciliation was  the major  activity. In terms  of output  evaluation, only  some hospitals  collected  their  output  data.  Coverage  of pharmaceutical  care  provision  among  the  new cases of diabetes mellitus, hypertension, psychiatric patients who received outpatient services was in unsatisfactory  level  (64-81%  of  all  new  cases).  Problems  of  coverage  of  pharmaceutical  care provision  were  also  found  in  the  in-patient  services.  Only  49.8%  of  the  admitted  patients  received medication  reconciliation  service  while  8.5%  of  them  received  discharge  counseling  service  from pharmacists. Conclusion: Manpower  is  required  for  expanding  pharmaceutical care  activities. Currently,  pharmaceutical  care  provision  in  community  hospitals  is  increasing,  however,  there  is problems in terms of coverage rate and data management system.