The effects of the Thai Rational Drug Use (RDU) Policy on Antibiotic Use in Hospitals of Mahasarakham Province (Health Region 7)
Keywords:
Rational Drug Use, RDU, Antibiotic Use, Hospitals, Health Region 7Abstract
This study aimed to measure the effects of the Thai rational drug use (RDU) policy, which was implemented by the MOPH in 2016, on antibiotic use in the outpatient department of hospitals in Mahasarakham province, Health region 7, and to determine the amount of antibiotic use as measured by DDD per 1000 OP visits. Based on the 43-file standard dataset, the antibiotic use focused on respiratory infections, acute diarrhea, and fresh traumatic wounds. Secondary data were collected covering 24 months before and after the policy implementation, it is to say between October 2015 and September 2017. For data analysis, segmented regression of interrupted time-series analysis (ITS) was applied to examine policy effects. A descriptive statistic was performed to examine antibiotic use.
The results showed that antibiotic use appeared to increase every month before the policy was implemented by 1.579 DDD per 1000 OP visits (95% CI: -16.708 to 19.902, p= .857), but it was not statistically significant. In the first month of the policy implementation, there was a decrease in antibiotic use of 25.639 DDD per 1000 OP visits (95% CI: -220.056 to 168.780, p= .786), but it was not statistically significant either. There was a decrease in the monthly trend of antibiotic use (relative to the pre-implementation trend), showing 24.480 DDD per 1000 OP visits (95% CI: -51.907 to 2.945, p= .077), but it was still not statistically significant. By specifying the post-trend after the introduction of the policy, the significant decrease in the monthly trend of antibiotic use was at a rate of 22.884 DDD per 1000 OP visits (95% CI: -42.071 to -3.696, p= .022). The antibiotic uses were 20,473.20 DDD per 1000 OP visits between October 2015 and September 2016 and 18,779.81 DDD per 1000 OP visits between October 2016 and September 2017.
According to the results, the rational drug use policy is related to a significant decrease in the antibiotic use trend. Thus, this policy is one of the important strategies that help to reduce multidrug-resistant organisms in hospitals.
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