Development of the guidelines for solving problems that patients with asthma didn’t receive inhaled corticosteroid in Sai noi hospital, Nonthaburi province.

Abstract

The objectives of this research were to study factors and causes that patients with asthma didn’t receive inhaled corticosteroid then developed the guidelines for solving the problems.
Method: This research was the action research. The researcher reviewed medical records to find out the factors and causes that the patients with asthma didn’t receive inhaled corticosteroid and determine the guidelines to solving these problems. The guidelines were discussed in group discussion of doctors, pharmacists and nurses then informed to the Pharmacy and Therapeutic Committee for practicing in the hospital and collecting data.
Result: From 274 patients were diagnosed with asthma form 1st September 2019 to 31st December 2019. 210 patients with asthma (76.64%) received inhaled corticosteroid. From reviewing the 64 patients with asthma who didn’t receive inhaled corticosteroid found the most common causes were that the patients didn’t receive the appointment from the accident and emergency department or missed the appointment that they received. From the causes of problems, it could be divided into 3 factors: 1) Medical care factor 2) Appointment system factor 3) Patient factor. After a solution to the problems was discussed in group discussion, the guidelines were determined and practiced such as when the patients with asthma came to the accident and emergency department, the doctor prescribed the inhaled corticosteroid as appropriate for all treatments, rights and made the appointment to asthma clinic or doctor’s appointment in the morning. After solving the problems and collecting the data from 1st April 2020 to 30th June 2020, the 213 patients were diagnosed with asthma, there were 177 patients with asthma (83.10%) receiving inhaled corticosteroid. 12 patients (5.63%) received the first inhaled corticosteroid from the guidelines of the solution. The outpatient department had the highest number of patients with asthma receiving inhaled corticosteroid (92.35%) while the accident and emergency department had the lowest number of patients receiving drug (26.67%).
Conclusion: The results of the research show that finding out factors, causes of the problems and developing of the guidelines for solving problems can increase the percentage of patients with asthma receiving inhaled corticosteroid to 83.10%, passed the criteria set by the Ministry of Public Health not less than 80%. Sai noi hospital operates project based on RDU hospital guidelines. The Pharmacy and Therapeutic Committee is a key for implementing and monitoring the outcome indicators.