Development and Assessment of an Approach for Promoting the Use of Herbal Medicines Included in the National List of Essential Medicines at Huai Yot Hospital, Trang Province

Abstract

Objective: To develop and assess aa approach for promoting the use of herbal medicines included in the National List of Essential Medicines (NLEM) at Huai Yot Hospital, Trang Province. Methods: This study employed a participatory action research (PAR) process conducted over two cycles. Sixteen healthcare professionals participated, comprising physicians, pharmacists, Thai traditional medicine practitioners, and nurses (four per group), together with hospital administrators. In cycle 1 (July–September 2024), the status of herbal medicine uses was analyzed using three years of retrospective data from the HOSxP database, supplemented by qualitative data collection through in-depth interviews with four physicians and focus group discussions with pharmacists, Thai traditional medicine practitioners, and nurses (four per group) to identify barriers. A multidisciplinary workshop was then held to design and implement promotional measures, including staff training, modification of the HOSxP alert system, and development of educational materials, with ongoing monitoring of prescribing rates. In cycle 2 (October–December 2024), findings from cycle 1 were reviewed and additional measures were implemented, namely development of a hospital’s handbook on herbal medicine and establishment of an internal communication system comprising monthly meetings, newsletters, and a LINE group. Quantitative outcomes were measured by comparing the number of prescriptions with herbal medicine across quarters, and qualitative data were analyzed using content analysis. Results: Prior to the intervention, the herbal medicine substitution rate was low (3.57–4.03%), below the 10% benchmark set by the Ministry of Public Health. The principal barriers were healthcare professionals' lack of confidence in the efficacy and safety of herbal medicines and the absence of clear prescribing guidelines. After completion of both cycles, prescription numbers of several herbal medicines increased markedly. Prescribing of Andrographis paniculata (Fa Thalai Chon) increased by 74.64% when comparing to that in the first and last quarters of the study. Sahatsatara use increased by 104.39% in cycle 2. Healthcare professionals' confidence in prescribing herbal medicines improved significantly. Conclusion: The two-cycle PAR process facilitated development of a herbal medicine promotion guideline tailored to the context of Huai Yot Hospital, enhanced healthcare professionals' confidence, and contributed to a systematic and sustainable increase in NLEM herbal medicine utilization.