Promoting Rational use of Metformin in Diabetic Patients, at Thawatburi Hospital Roi-Et Province

Abstract

Purposes : To review the system and create an alert mechanism promote the rational use of Metformin and reduce the inappropriate prescribing of Metformin.

Study design : Action Research

Materials and Methods : The research was an action research in diabetic patients receiving Metformin at least one follow-up visit per year. The sample consisted of type 2 diabetic patients who receive Metformin prescribing and the measurement of eGFR was 2,973 patients at Thawatburi Hospital and primary care units of Thawatburi  health service network, were collected from October 1, 2019 to September 30, 2021 and analyze the data using descriptive statistics.

Main findings : The model for promoting the rational metformin use includes (1) Policy-making by PTC, (2) Personnel knowledge management,(3)access to necessary patient information and prescriptions via CPOE and dispensing program aids, (4) CKD Pop Up Alert system, (5) manpower management, and (6) multidisciplinary roles and pharmacists in monitoring the suitability of prescribing medications, and In the first cycle, rational metformin use (96.21%) was found in patients with CKD stage 1 (97.83%), CKD stage 2 (98.88%), CKD Stage 3a (95.43%), CKD Stage 3b (69.26%), and second cycle; metformin using reasonable (98.21%), CKD Stage 1 (99.23%), CKD Stage 2 (99.54%), CKD Stage 3a (98.49%), CKD Stage 3b (79.87%), and inappropriate drug prescribing were reduced. However, CKD stages 4 and 5 were prescribing, 65 and 5 times in first cycle and 35 and 2 times, respectively.

Conclusion and recommendations : Results from research on a rational promotion of Metformin, the Metformin dose was adjusted to be more suitable for chronic renal failure in patients, But it was also found to be contraindicated in patients with  CKD Stage 4 and 5.