Development of Medication Safety Standard System for Primary Care Units in Lampang Province

Abstract

This study aimed to investigate the input factors influencing the development of a medication safety standards system, assess the awareness of medication safety standards, develop necessary and contextually relevant criteria, and evaluate the baseline status of implementation according to these criteria within primary care units. The study population comprised pharmacists working in primary care units, personnel responsible for primary healthcare at the provincial, district, and primary care unit levels under the Lampang Provincial Public Health Office and local administrative organizations, as well as primary care units within Lampang Province, totaling 61 units. The research was conducted in three phases: Phase 1 involved a qualitative study of the situation and input factors through focus group discussions, employing purposive sampling with two groups totaling 18 participants (8 and 10 participants, respectively). For the awareness survey, the sample included all personnel within the primary care units. Phase 2 consisted of participatory workshops to develop draft standards and guidelines for monitoring and evaluation, using purposive sampling to select two groups totaling 22 participants (14 and 8 participants, respectively) for workshop participation. Phase 3 involved pilot testing the criteria and evaluating an online assessment approach, with the sample comprising 61 primary care units, each represented by one key informant. Analyze qualitative data using content analysis based on the specified key issues and present it descriptively. For quantitative data, process it with descriptive statistics, including frequency distribution, percentage, mean, and standard deviation. The findings revealed four interrelated systemic factors influencing the development of medication safety standards: policy factors, support factors, standards criteria, and evaluation system factors. Awareness of medication safety standards among primary care units ranged from 35.78% to 56.05%, with the highest awareness observed in outpatient pharmaceutical services and the lowest in personnel competency development. The medication safety standards selected by experts were deemed appropriate and contextually suitable. A total of 178 criteria from the initial draft of 233 criteria cover 4 dimensions and 12 areas. The baseline survey results from 34 service units (accounting for 55.73%) found that more than 50% of the criteria were implemented in frontline service areas such as medication dispensing, pharmaceutical care, adverse event monitoring basic drug inventory management. The dimensions posing challenges with a high proportion of “not yet implemented” are Procurement Real-time information systems. The evaluation of the online self-assessment system (SarPCU) showed that users understood the criteria, found it convenient to use, and they were satisfied with the system at a good level. In summary, the development of safety standards for primary care service units aligns with the local context, and baseline data on awareness and implementation can be used to continuously improve medication quality and safety.