Needs for Competency Improvement in Drug Dispensing and Counseling Services among Service Providers of Sub-District Health Promoting Hospitals in Kanchanaburi

Abstract

Objective: To evaluate and compare competency levels on existing drug dispensing and counseling (DDC) services and expected competencies among service providers of sub-district health promoting hospitals (SDHPH) and to collect problems, difficulties, and suggestions related to improvement of such competency. Methods: The study was mixed-method research. Stage 1 was a quantitative study involving cross-sectional survey using a questionnaire. The subjects were 144 service providers mainly responsible for DDC in SDHPH. Stage 2 was a qualitative approach with in-depth interviews in 10 informants from stage 1. Results: For stage 1, all 144 questionnaires were completed and returned. The subjects needed improvement on the following competencies--1) process of checking the medication before dispensing in 5 areas including diagnosing the severity of drug-related problems (DRPs), identifying DRPs, resolving DRPs, checking the appropriateness of techniques in drug administration and medication dosage. 2) For the process of DDC services, the subjects needed improvement in 7 competency areas including recording an incidence of medication error, evaluating and managing a patient with drug allergy, recording a reminder for a patient taking high alert drug in computer system, recording a reminder for a patient with drug allergy, checking medication adherence, recording data and marking a symbol for a patient with drug allergy, and giving verbal education on drug utilization together with written information.3) For the process of evaluating DRPs and patient refer in 4 competency areas including identifying DRPs and factors affecting the occurrence of DRPs at home, identifying DRPs and factors affecting the occurrence of DRPs, diagnosing severity of DRPs and referring patients, and evaluating the resolution of DRPs. The existing and expected competencies in all areas mentioned above were significantly different. For stage 2 of study, identified problems and difficulties in DDC services included lacking of knowledge, skills, experiences, language comprehension, and linking patients’information as well as insufficient manpower and technical manuals along with guidelines or academic information. Suggestions in improving competencies in DDC included  training, increase of manpower, provision of technical manuals and guidelines or academic information, pictograms, drug label in a foreign language and foreign language communication guides, and a better linking of  information. Conclusion: The service providers in SDHPHs still need competency development on DDC services in primary pharmacy services, and guidelines for quality development of SDHPHs to become a starred one. Therefore, training course and support for practice in the needed areas are needed to improve the efficiency of working.