Development of the Model for Resolving Problems in Drug Use among Patients with Type II Diabetic Mellitus by Using Appreciative Inquiry in Primary Pharmacy Services : Case Study of Bueng Ngam Sub-district, Roiet Province

Abstract

Objective: To study positive experience in resolving drug related problems (DRP) among patients with type 2 diabetes mellitus (T2DM) by using appreciative inquiry (AI), design model for resolving DRP based on the obtained information, and evaluate the outcomes of implemented model. Methods: This study was an action research by identifying positive experiences from 13 T2DM patients with best practices in resolving DRP and conducting focus group discussion with 6 multidisciplinary team members in the diabetes clinic in Nong Phok District, Roiet. The researchers analyzed the data to identify common factors and outstanding factors in order to design model for DRP. Subsequently, the model was implemented in 23 diabetic patients who lived in Bueng Ngam sub-district, and evaluated its outcomes. Results: The model for resolving DRP among T2DM patients in this study was the ACIN model consisting of 1. awareness 2. counseling by pharmacists on problems, causes and resolutions. 3. innovation supporting drug use. 4. participation of network within the community. The assessment before and after using the ACIN model revealed that number of DRP decreased from 58 problems or an average of 2.52 problems per case to 12 DRP or an average of 0.52 problems per case. Medication non-adherence decreased from 43 problems or an average of 1.87 problems per case to 8 problems or an average of 0.35 problems per case. After the implementation of the ACIN model, medication adherence as measured by pill count increased significantly from 82.19±3.78 percent to 90.77±1.72 (P <0.005). Conclusion: Development of the model for resolving DRP in patients with T2DM by using AI in primary pharmacy services reduces DRP and medication adherence among diabetic patients.