Promoting Uthaithani to Be a Rational Drug Use Province

Abstract

Objective: To promote all districts in Uthai Thani lading to a rational drug use (RDU) province and to evaluate the results of such efforts. Method: This action research consisted of activities to promote RDU in hospitals, sub-district health promoting hospitals and communities. The study compared outcomes before and after promoting efforts including RDU literacy among subjects of 589 Thais aged 15 years and over, and the prevalence of unsafe health products in 589 households. Trained research assistants collected data using a survey form. Results: Promoting Uthai Thani into a RDU province was carried out according to the framework of six building blocks plus, consisting of the promotion of 1) leadership and governance, 2) health workforce, 3) service delivery system, 4) information system, 5) access to essential medicines and health technology, 6) financing and 7) collaboration. Implementation consisted of 4 steps including planning, performing, reflecting and improving for two cycles. The outputs of the efforts were all districts implementing RDU promotion both in health care settings and in the communities through RDU coordinators at the provincial, district and sub-district levels as agents to drive the promotion of RDU or to resolve problems on inappropriate uses of drugs and health products with participation from all stakeholders. Outcomes after the promotion efforts were mean scores on RDU literacy significantly increasing from 38.08 ± 9.59 to 44.26 ± 5.76 (P < 0.001), household with antibiotic left-over significantly decreasing from 17.83% to 14.16% (P = 0.009), and the prevalence of households with potentially steroids contaminated health products significantly decreasing from 11.20% to 3.20% (P < 0.001). Conclusion: The promotion of Uthai Thani Province to become a RDU province with the framework of six building blocks plus through the RDU coordinators as change agents results in the implementation of participatory RDU promotions in every district. The efforts led to the improved knowledge on RDU among public and the reduction of the prevalence of unsafe health products in the household.