Development of an Inpatient Pharmaceutical Service Model to Prevent Cross-Reactivity in Drug Groups with a High Cross-Reactivity in the Context of Wapipathum Hospital, Mahasarakham Province

Abstract

This action research aimed to study and develop a model for inpatient pharmacy services to prevent
cross-reactivity to drugs in groups that have a high chance of cross-allergic reactions at Wapipathum
Hospital. It was conducted between April 2022 - May 2023 using a specific sample selection method
including (1) 25 multidisciplinary people, (2) 160 inpatients with a history of allergy to beta-lactam
drugs or NSIADs or antiepileptic drugs, who have conditions or diseases that require medication in groups
where patients have a chance of having cross-reactivity, (3) 30 practitioners who use the developed
model. It used the PAOR cycle of Kemmis and McTaggart, and applied the participatory process
concepts. Data were collected using observational forms, group discussion recording forms, patient record
forms, and satisfaction assessment forms. Quantitative data were analyzed using descriptive statistics and
qualitative data were analyzed using content statistics. The research results found that the model consists
of 6 main processes as follows: (1) set clear and easy-to-understand guidelines; (2) create accurate and
consistent knowledge and understanding; (3) adjust the model to include drug allergy information; (4)
provide drug allergy information at every step; (5) assign responsible persons; and (6) review together
regularly. After using the model, no incidence of cross-reactivity was found in the samples, and the
sample group was satisfied with the model at a high level. In conclusion, the developed model can prevent
cross-reactivity in drug groups with a high chance of cross-reactivity in inpatients within the context of
Wapipathum Hospital. The success factor is the use of multidisciplinary perspectives related to the medicine
system to help develop effective models. This may be expanded to include other drug groups or may be
adapted to the context of outpatient pharmaceutical services.