System management for rational drug use in Nonsung district network

Abstract

This participatory action research aimed to manage drug system for patient drug safety and decrease drug consumption. Period of study was divided in to three phases of 1) In 2014 situation analysis for the past problems of irrational drug use. 2) In 2015-2016 join the RDU hospital project. 3) In 2017-2019 developed and implemented of RDU service plan project, sub-district health promoting hospital accreditation criteria and guideline of RDU in community. To achieve RDU hospital goal by systematic RDU development through participation and outcome evaluation.
Results: After manage drug system for RDU project in Nonsung hospital and network.
1. Regarding drug safety, the study showed that drug system management which included prescription analysis, medication safety system management, antimicrobial resistance management and reduction of irrational drug use in community increased patient drug safety and appropriate use of drugs.
2. Regarding reduction of expenditure on drugs, RDU policy showed potential drug cost saving. Comparison between 2014 and 2019, before and after RDU implementation, expenditure on essential drugs (ED) procurement increased from 88.38% to 97.75%, expenditure on ED use increased from 66.14% to 96.12%. Drug inventory rates dropped on target. Limiting the use of extravagant drugs, the expenditure on methylsalicylate cream decreased from 349,971 baths in 2015 to 133,584 baths in 2019. Dual antiplatelet use guideline promotion decreased clopidogrel costs from 607,750 baths in 2016 to 71,116 baths in 2019. Tracking patient’s asthma/COPD inhaler remaining from 2017-2019 saved 733,086 baths on drug cost. Restricted drug policy and Antibiotic Smart Use measures in 4 diseases, decreased antibiotics cost significantly after policy implementation (p<0.01), and saved 1,348,098 baths on drugs cost during 2015-2019.
Conclusions: RDU project in Nonsung district was effective, the results showed that all indicators of RDU project achieve target and passed the 3rd level RDU hospital indicators of Ministry of Public Health RDU project, The project improved patient drug safety and decreased drug consumption because of a good system management and good cooperation of network partners in health system.