Outcomes of the Program on Rational Drug Use Hospital in Nonghong District, Buriram

Abstract

Objective: To evaluate the effects of the program on rational drug use hospital in Nong Hong District. Buriram on awareness of the rational use of drugs among medical personnel and indicators of rational drug use. Method: The researcher collected the data on 25 indicators in the pre-project period (Oct 2015-Sept 2016) and 3 months after program implementation (Oct-Dec 2016). The indicators Include 5 indicators and 20 performance indicators as detailed in the Manual “Service plan: rational drug use” published by Ministry of Public Health. In addition, the researcher also measured awareness on rational use of drug using questionnaires in 8 physicians and dentists and 95 other health personnel. Results: After the program implementation, awareness on the issue among physicians and dentists increased significantly from 90.50±1.60 to 104.00±2.07 (P<0.001) (out of the full score of 120). The awareness for other health professionals increased from 46.67±7.72 to 56.85±3.04 (P <0.001) (out of the full score of 65). After program implementation, Nong Hong Hospital established complete working procedures as specified in the RDU hospital program including those in policy formulation, measures and activities to promote rational drug use, development of information systems for measuring indicators, follow-up and evaluation and management of drug resistance. Program implementation dramatically improved seven indicators from “failing the standard” to “meeting or exceeding the criteria”. Two other indicators failing the standard before the program implementation showed a large improvement, but still did not meet the criteria (the use of metformin in diabetic patients and the use of antibiotics for acute diarrhea in sub-district health promoting hospitals and primary care units). Six indicators well satisfied the criteria before starting the program, hence they remained at the same level after implementation of the program. The program showed no impact on 5 indicators, ie, their baseline level failed the criteria at the pre-program phase, these indicators remained at a level that was far below the criteria after the implementation of the program (antibiotic use in upper respiratory tract infections and acute bronchitis, acute diarrhea, wounds from accident, normal full term vaginal delivery, prescribing double RAS blockages (ACEIs/ARBs/ Renin inhibitors) in the treatment of hypertension). Conclusion: After the program implementation, Nong Hong Hospital's medical staff was more aware of the rational use of drugs. The Hospital also established processes that promoted the use of drugs rationally. The Hospital passed the criteria in 13 indicators out of a total of 20.