Development of a Multidisciplinary Pharmaceutical Care Model in Thai Traditional Medical Cannabis Clinics at Huai Koeng Hospital, Udon Thani Province

Abstract

Objective: To develop a multidisciplinary pharmaceutical care model at the Thai traditional medical cannabis clinic in Hua iKoeng Hospital (Cannabis Clinic). Method: This study was an action research in the planning phase. Firstly, information on drug-related problems (DRPs) was collected from the pharmaceutical care record form of 120 patients who received continuous treatment at the Cannabis Clinic. Subsequently, the researchers purposively selected 19 patients for in-depth interviews on adherence to the use of cannabis oil. The multidisciplinary team designed work procedures and pharmaceutical care model by means of focus group discussions with 13 relevant medical personnel. Data on DRPs obtained from patients were taken into account and lean concept was applied as a tool in designing. Results: The study revealed that the majority of DRPs that affected safety were inappropriate drug use behavior. The results from patient interviews identified factors affecting adherence to drug treatment including: patient factor, drug factor, factors on medical personnel and service systems, disease factor, social and economic factors. Developing pharmaceutical care procedures and models using lean concepts expanded the roles of multidisciplinary team. Nurses were responsible for history taking, screening, and assessment of addiction, and educating patients on concomitant diseases or chronic diseases. Pharmacists were responsible for identifying and resolving DRPs, medication reconciliation, patient education on diseases and cannabis through video clips, setting up a line group for staff and patients so that patients could report and inquire about drug side effects in a timely manner, and proactive adverse drug monitoring through telephone calls. Thai traditional medical doctors were responsible to treat patients and prescribe cannabis oil according to current treatment guidelines. Physicians were responsible for providing consultations or treating referred patients with complex diseases, multiple comorbidities or no improvement after 6 weeks of cannabis oil use. Conclusion: The procedures and model of pharmaceutical care in cannabis clinics developed by the multidisciplinary team should be implemented in real practice. It is expected to reduce DRPs at both patient and prescriber levels. This should result in effective and safe use of cannabis oil among patients.