Evaluation of Rational Drug Use Performance at Public Health Service Units in Ranong Province, Thailand

Abstract

Background: Irrational Drug Use is a major global health problem, especially in developing countries. The World Health Organization estimated that over 50% of drug use was irrational use of drugs. Patients, medical professionals, and the health systems did not encourage the rational drug use, which affected both the health system and the economy. The ministry of public health of Thailand has determined that the Rational Drug Use (RDU) is an important policy. Ranong province has implemented the RDU policy according to the national RDU policy since 2018.

Objective: To evaluate the performance according to the indicators of RDU of health service units in Ranong province and to study the success factors of the implementing RDU indicators.

Methods: This was a mixed study, cross-sectional quantitative and qualitative that used the CIPP model. It studied between October 2019 and March 2021. The number of medical professionals in hospitals and district health promotion hospitals in Ranong province was a population at 150, which included physicians, dentists, pharmacists, and prescribing officers by using a questionnaire. Then it used an in-depth interview with a purposive sampling method of provincial public health doctors, hospital director, district public health, supervisor of RDU indicators in government inspection from the Thai Food and Drug Administration, and officers in charge of RDU work at 14 samples was conducted.

Results: Quantitative research showed that the overall assessment results were at a high level, with an average of 3.69 out of a total of 5. The areas with the highest assessment score were the context side, which had an average of 3.80 levels, followed by the produce side that had average of 3.78 levels, the process side had an average 3.68 levels. And the input side had an average of 3.54 level, respectively. Qualitative research Interviews with 14 informants who were involved in the implementation of the RDU indicators of Ranong province revealed that the success factors in implementing the RDU indicators of Ranong province included: (1) policy of executives; (2) support for the implementation of RDU indicators; (3) Prescribers in the health service units; (4) training and control of implementation RDU indicators; (5) RDU community; (6) Research innovations and technology systems.

Conclusion: The evaluation of the key performance indicator of RDU by the health service units in Ranong province was a high level. Context had the highest average score. The result reflected the potential of executives and operators who paid attention and cooperated in the operation. In terms of input, the operation had the lowest average scores; however, it stayed in the high range. As a result, the provincial health offices should allocate budgets, personnel, and equipment for its operations appropriately, adequately, and continuously. There is a policy management system for the management, community promotion of reasonable drug use, and technological developments to encourage the long-term success of the RDU indicator implementation.