Participation of Primary Health Care Personnel in the Development Process for Drug Dispensing and Counseling Services

Abstract

Objective: To study the development process for the system of drug dispensing and drug counseling services by the participation of primary health care personnel and to identify factors affecting the development process. Method: This study was participatory action research conducted at Wangchao sub-district health promotion hospitals, Wangchao District, Tak Province. The research team comprised 1) core research team consisting of five primary health care personnel 2) supporting team who were nurses from the nodal hospital, pharmacy assistants, village health volunteers, community leaders and the chiefs in primary health care 3) target patients who were 136 diabetic patients. The researchers collected the data by observation, informal interview, focus group discussion, and participant brainstorming. Results: The development processes for drug dispensing and drug counseling services in the context of primary care unit included the following crucial steps: 1) understanding the local context of community and primary health care personnel in the target area 2) building core research team 3) analyzing problems, identifying causes and setting activities for problem solving 4) planning for the processes of drug dispensing and drug counseling services 5) implementing the services as planned 6) performance analysis 7) analyzing the factors affecting the development of the system 8) refining the system for drug dispensing and drug counseling. The core research team developed two working plans for improving the drug dispensing and counseling system; 1) a training course for improving the core research team’s knowledge on medicines, and 2) activities for improving service system for caring diabetic patients. After the implementation of the plans, the core research team involved in every step of the development process resulting in the reduction of the problems in the system, the shift of their working paradigm by regarding the interests of patients as a primacy, and the decrease of drug related problems among diabetic patients. Conclusion: The participatory action research could improve the cooperation and learning processes of the core research team. The important internal factors contributing to the development process of drug dispensing and drug counseling service system were past experience from the work among core research team, awareness of the problems in the system, gaining respect from others, readiness to the change and leadership. External factors were the cooperation from the supporting team and target patients, research design emphasizing on the participation and the limited time for project implementation.