The Mutual Collaborative Action Research for Development of Rational Drug Use Promotion Model for Chaturaphakphiman District Health Network, Roi Et

Abstract

Background: Rational Drug Use (RDU) is an urgent situation that requires rapid action. The RDU affects patient care in terms of treatment effectiveness, cost-effectiveness, safety, and drug adverse events, including the problem of antimicrobial resistance.

Objectives: To study the situation, develop a model and evaluate the model for promoting rational drug use with health care network in Chaturaphakphiman, Roi Et.

Methods: Participatory action research, consisted of a rational drug use committee and network. This research was conducted from October 2021 to September 2023 in 3 phases: the situation analysis phase, the model development phase, and the data evaluation phase. Collecting data by using the hospital indicator report, Health Data Center (HDC) database, and questionnaires for focus group discussions. Data were analysed using frequency, percentage, mean, standard deviation, and content analysis.

Results: The situation analysis phase found irrational drug use problems, such as antibiotic prescribing for normal labor full-term pregnancy, prescribing antibiotics in patients with small, uncontaminated wounds within 24 hours, prescribing domperidone for stimulating lactation in postpartum, duplicated prescribing of non-steroidal anti-inflammatory drugs (NSAIDs), lack of history taking and drug consumption in antenatal care (ANC), not following upper respiratory infection (URI) and diarrhea treatment guidelines, lack of patient education and advice, and lack of promoting community on how to take loperamide in diarrhea properly. The developed rational drug use promotion model consisted of factors on management, operation process, and operational efficiency. The data evaluation phase found that the development of the first cycle passed RDU level one, but there were problems related to overuse of antibiotics in URI, acute diarrhea, fresh wounds, and normal labor the second cycle passed RDU level two, but it found problems of prescribing metformin in diabetic patients that were < 80%, and the third circle passed the RDU indicator level three.

Conclusions: The research suggested that the improved developed rational drug promotion model contributed to the achievement of promoting rational drug use in hospitals.