Effects of the Intervention on Steroid Adulterated Health Products at the Communities in the Catchment Area of Khun Lan Sub-district Health Promoting Hospital, Dok Kham Tai District, Phayao

Abstract

Objective: To study the effect of the intervention on steroid-adulterated health products (SAHP) in communities in the catchment area of Khun Lan sub-district health promoting hospital, Dok Kham Tai district, Phayao. Method: This study was an action research on the intervention on the problem of SAHP uses in the community. The study was divided into 3 phases. Phase 1 was the survey of households in the community prior to the intervention. Phase 2 was the implementation of the intervention for the problems including the treatment of patients with side effects from SAHP, control of sources of drug distribution within the community, creating a screening system for patients with side effects from steroids during home visits, establishment of a process for identification and preliminary examination of the products at risk of steroid contamination, and risk communication by health volunteers within the village (HV). Phase III was the evaluation of intervention for the problem in the community. Results: After the intervention implementation, the problems of using the SAHP significantly reduced from 12 items in the pre-intervention phase to 2 items. Of the 12 patients with adverse events from SAHP, moon face, hypertension, weight gain, buffalo hump, ecchymoses and gastrointestinal disorders (such as stomachaches, burning stomach) were identified in 10, 8, 8, 5, 4 and 3 patients, respectively. Eleven patients voluntarily stopped using SAHP, allowing examination by a physician before discontinuation, and being under the care of nurses in sub-district health promoting hospitals without adrenal crisis. One patient continued but reduced the use of SAHP. After the intervention, physical re-examination of patients found that the patient's body weight significantly reduced from 63.75±5.50 kg to 59.42±6.17 kg and systolic blood pressure significantly decreased from 155.50±13.83 to 129.17±16.35 mm Hg after discontinuation of the products. Patients had fewer Cushing symptoms, having no ecchymoses, and less other symptoms compared to those before the start of the program. After the intervention implementation, the community was been alerted to the problem of SAHP usages, resulting in the establishment of surveillance process for unsafe drug and the screening of patients with Cushing symptoms by HV. Setting up of measures within the community by the network of community leaders, temples and HV for examining and monitoring drugs peddlers or salesmen together with rapid communication through Line application led to the reduction of SAHP in the area. Conclusion: Effective effort for the problem of SAHP requires continuous cooperation from the community. When the community recognizes the problem and the dangers faced by people in the community, it will be able to set up the measure for continuous and sustainable resolution of the problem.
Keywords: steroid, steroid adulterated health product, consumer protection, community