Prescription Review by Community Pharmacy Joining Community Caring Clinic under the National Health Security Scheme: A Case Study of Mahachai Community Caring Clinic Nakhon Ratchasima

Abstract

         Unlike the model in developed country, community pharmacists in Thailand scarcely receive a prescription for drug dispensing. In year 2004 there was a new model developed in Mahachai community, Nakhon Ratchasima province. This new model had community pharmacy incorporated with a community caring clinic and was responsible for drug dispensing. After implementing the  new model for a year, a retrospective descriptive study was conducted in order to 1) determine for pattern of illness from the prescription review and 2) determine for drug related problems that pharmacist could detect and had them corrected. The study was conducted as a descriptive study by retrospective review of 4,816 prescriptions prescribed during November 2004 - October 2005. Data was analyzed by descriptive statistics.

        The results showed that the three most common illnesses analyzed from prescriptions were respiratory illness, cardiovascular diseases and endocrine diseases respectively. Patients’ illnesses were found to be acute minor ones (49.1%), chronic diseases (37.4%) and emergency and/or required further referral (13.5%). Prescription contained 1-9 items of drug with a mode of 3 items.

The average cost of medicine was 52.5 baht per prescription. Cost of medicine for acute minor illness was 30.1, for chronic disease was 97.9 and for emergency and/or required further referral was 38.8 baht per prescription. The community pharmacist detected 2.78 percent drug related problems from the prescriptions. These drug related problems were inappropriate prescribing, inadequate or too high doses, inappropriate frequencies and untreated indications. The detected problems had been reported to physicians for corrections. It was concluded that separation of prescribing and dis-pensing accommodated a process of double checking for any drug related problem which enhanced a more appropriate prescribing and safety of drug use process.

Key words: separation of prescribing and dispensing, drug related problems, prescription review, community caring clinic, community pharmacy