Development of a Tool for Evaluating the Quality of Medication Management in Schools

Abstract

Objective: To develop a tool for assessing the quality of medication management in schools within Thailand for use in monitoring the problems and improving quality in this domain. Methods: The study consisted of 5 phases. Phase 1 involved the collection of the criteria for assessing medication management in schools from previous studies. Phase 2 involved the online-interviews with 6 experts in medication management in schools during February 2024 to obtain their opinions for improving the collected criteria. Phase 3 was a Delphi survey with an online questionnaire in 21 experts to find out their agreement with the criteria on a scale of 1-5 (strongly disagree to strongly agree). The survey was conducted from March to April 2024. Phase 4 involved another Delphi survey with an online questionnaire in 28 experts on appropriate timeline for implementing each criterion with 5 choices (never implement, implement immediately, implement in the next 2, 5, or 7 years). The survey was conducted from May to June 2024. Phase 5 was the development of assessment methods for the criteria identified as critical defects. Failure to meet these criteria resulted in failing the overall assessment. The study conducted through a 110-minute online brainstorming and online-interviews among 8 experts in school medication management during August 2024. Results: In phase 1, the researchers identified 40 criteria for assessing medication management with 37 non-critical defect criteria and 3 critical defect criteria. Following the interviews with experts in phase 2, the number of criteria was expanded to 49. Results from the Delphi survey at the first round in phase 3 indicated that the experts reached a consensus on the use of all criteria with 40 criteria having a median of 5.00 (strongly agree) and an IQR of 0.00, and 9 criteria  with a median of 5.00 and an IQR of 1.00. The survey on criteria agreement was therefore conducted only once. The number of criteria was expanded to 51 after phase 3 study. The Delphi survey at the first round in phase 4 reached a consensus on the immediate use of all 51 criteria with 42 criteria having a median of 5.00 and an IQR of 0.00, 7 criteria with a median of 5.00 and an IQR of 1.00, and 2 criteria with a median of 5.00 and an IQR of 0.25. The survey in phase 4 was conducted once. The study resulted in 51 criteria for the assessment of medication management in school with 43 non-critical defect criteria and 8 critical defect criteria. Additionally, specific assessment methods for the critical defect criteria were formulated in phase 5. Conclusion: The development of the assessment tool for medication management in school, through a variety of processes with the involvement of experts in relevant area, has resulted in a tool ready for further testing.