Development of a system for managing medicines returned from patients of Outpatient medicine dispensing service in Huahin Hospital

Abstract

Leftover medications among patients with chronic diseases, especially in the elderly who require multiple medications continuously, is a common problem in Thailand’s public health system. The main causes are the over-prescription of medications, changes in treatment plans, and patients discontinuing medications without consulting physicians. These issues lead to economic waste, risks in medication use, and environmental impacts. Although some patients regularly return leftover medications to the outpatient pharmacy at Hua Hin Hospital, the lack of a structured management system prevents the reuse of quality medications. Therefore, the researcher proposed the development of a drug return management system to enhance the efficiency of pharmaceutical resource management in a safe and beneficial manner. This research employed an action research approach, divided into four phases: problem analysis, planning, system implementation, and evaluation. Data was collected over a period of 5 months and analyzed using descriptive statistics. The study found that a system for managing returned medications was successfully developed. It included a drug return form, criteria for medication screening, and quality assessment. A total of 343 patients returned unused medications, and medications worth 564,766.72 Baht were able to be reused. The medication with the highest reusable value was Imatinib 400 mg, accounting for 180,958.40 Baht (32.05%). The most common reason for medication returns was prescriptions exceeding the scheduled follow-up date (45.19%), followed by unknown reasons (17.20%), and changes in treatment regimen by physicians (9.33%). The drug group with the highest return value was anticancer drugs, totaling 199,368.10 Baht. The drug group with the highest number of returns—both reusable and non-reusable—was antihypertensive drugs. The developed drug return management system effectively reduced medication waste, promoted systematic pharmaceutical resource management within the hospital, and can be used as a model for implementing medication return systems in other healthcare facilities.