Development of Monitoring and Evaluation System for Rational Drug Use by Pharmacy and Therapeutics Committee

Abstract

Background: Surin Hospital achieved the status of a rational drug use (RDU) level 1 hospital in 2016 and level 2 from 2017 to 2021. Therefore, further strategies need to be developed to achieve level 3 RDU hospital status.

Objectives: To develop a monitoring system for rational drug use by the Pharmacy and Therapeutics Committee (PTC) and to study the outcomes of its implementation.

Methods: This study employed participatory action research (PAR) through the PTC over a two-year period (October 1, 2020 - September 30, 2022). The study was divided into four phases: 1) situation analysis, 2) strategy development under the PLEASE mechanism, 3) implementation and monitoring, and 4) evaluating outcome using descriptive statistics and comparing results before and after development using the chi-squared and t-test.

Results: The study identified problems in policy setting, goal setting, communication of policies to implementers, and the lack of a clear monitoring system by the PTC. Strategies specific to the context and a monitoring system were developed. Before development, 5 out of 12 indicators (41.7%) were not met. After development, 100% of the indicators were met. The use of antibiotics for upper respiratory tract infections, diarrhea, and clean wounds decreased from 29.9%, 22.3%, and 41.1% to 8.4%, 14.2%, and 38.6%, respectively. The use of metformin in diabetic patients and inhaled corticosteroids in chronic asthma patients increased from 78.2% and 78.3% to 83.9% and 82.1%, respectively, with statistically significant differences (p < 0.001), resulting in the hospital achieving level 3 RDU hospital status.

Conclusion: The development of a monitoring system with context-specific strategies by the PTC resulted in achieving level 3 RDU hospital status.