An Evaluation of Rational Drug Use Model within the 7th Health Region

Abstract

Background: The irrational use of medications is a global issue leading to increased healthcare costs and higher mortality rates due to antibiotic resistance. The World Health Organization (WHO) has urged countries to implement essential policies to ensure rational drug use. In 2016, Thailand’s Ministry of Public Health introduced the Rational Drug Use (RDU) Service Plan in public hospitals. By 2022, this initiative extended to the community level, establishing RDU Province indicators with complex measures from the sub-district to the provincial level. Initial implementation has not met the targets, prompting this study to identify effective strategies and policies to achieve these goals in Health Region 7.

Objectives: The study aims to investigate the current challenges in implementing the rational drug use policy in Health Region 7 in 2023, develop a model to drive this policy effectively, and evaluate the developed model.

Methods: This research and development study was conducted in Kalasin, Khon Kaen, Maha Sarakham, and Roi Et provinces from May to December 2023. Data collection involved interviewing provincial RDU officers, reviewing secondary data from the Health Data Center (HDC), and summarizing inspection reports. The developed policy model was assessed using questionnaires distributed to 64 pharmacists responsible for RDU implementation in Health Region 7.

Results: Problems identified through interviews and inspection reports were categorized into three levels: upstream (community RDU), midstream (hospital and PCU RDU), and downstream (district and provincial RDU). The research utilized these insights and relevant studies to develop a driving model for RDU policies in Health Region 7, formulated as a Matrix Scoring: Topic RDU Province adapted from Health Region 11's Matrix Scoring Inspection. This model defined critical measures for each implementation level, from upstream community engagement to downstream district policies, ensuring a coherent approach with designated responsibilities. The CIPP Model evaluation showed that over 70% of the participants believed the Matrix Scoring measures were consistent with RDU policies, practical, and capable of achieving the indicators at each level.

Conclusion: The developed model was relevant and suitable to be used as an approach for driving the policy on rational drug use in the 7^th Health Region.