Development of a Rational Drug Use Model for Substituting Modern Medicines with Herbal Medicines in Health Service Units, Saraburi Province

Abstract

Introduction and Objectives: Although the Ministry of Public Health aims to promote herbal medicines as rational alternatives to conventional drugs across public and private healthcare units to mitigate inappropriate drug use, practical implementation remains constrained by the lack of structured models and low acceptance among medical professionals. This study aimed to investigate the situation, develop, and evaluate a rational drug use model for substituting conventional medicines with herbal alternatives in health service units within Saraburi Province.

          Method: This participatory action research involved 30 public medical personnel and 24 private community pharmacists, focusing on three symptom groups (fever/cough/sore throat, diarrhea, and muscle pain). The study comprised three phases: 1) pre-implementation situational analysis via in-depth interviews, 2) model development based on the V-Shape Health Literacy Theory, and 3) pre-and-post evaluation comparing prescribed conventional and herbal drug data. Research tools were validated for content validity by 3 experts. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using frequencies, percentages, and the Chi-square test to compare proportional differences.

          Results: Phase 1 revealed that Tao Wan Priang, Sahatsara, and Ya Luang Pid Samut were unavailable in drugstores. Phase 2 yielded a multi-component model: training, one-page infographics, an information application, a LINE support group, and a learning forum. Phase 3 showed significant increases in herbal use across all symptoms: for fever/cough/sore throat, Fah Talai Jone use rose (5.25%–15.25%), reducing Paracetamol (10%–15%), Ibuprofen, Amoxicillin, and Roxithromycin use. For diarrhea, Ya Luang Pid Samut use increased (20.24%), decreasing Loperamide (0.5%–12%) and Norfloxacin (3%–10%). For muscle pain, the use of Tao Wan Priang, Sahatsara, and Plai cream increased by 2%–8%.

          Discussion: The developed model successfully stimulated the substitution of conventional medicines with herbal alternatives. The marked increase in herbal prescriptions alongside the reduction in conventional drug consumption demonstrates the model's practical utility as a viable framework for expanding rational herbal medicine integration.

          Conclusions and Recommendations: This Rational Drug Use (RDU) promotion model effectively increased the utilization of herbal medicines in both public and private healthcare facilities. To drive sustainable change, key policy interventions should be reviewed and effectively implemented in practice. Priority action areas include establishing support systems, such as an herbal RDU application, fostering engagement among private and academic networks, and enhancing public health literacy. Furthermore, robust monitoring and evaluation systems alongside localized communication of successful outcomes should be implemented.