Situation and Factors Affecting the Implementation of Rational Drug Use in Private Hospitals

Abstract

The assessment of the rational drug use (RDU) in private hospitals throughout Thailand has never been reported. Therefore, this research aimed to study the situation of rational drug use in private hospitals and analyze the factors affecting its implementation. Data from the 2021 to 2024 questionnaire surveys were analyzed. The questionnaire contained 3 parts: 1) general information of the hospital, 2) the rational drug use implementation according to the PLEASE (pharmacy and therapeutic committee, labeling, essential tools, awareness, special populations, ethics in prescription) guidelines, and 3) open-ended questions (only in 2024) asking for opinions on factors affecting the rational drug use implementation in private hospitals. More and more private hospitals voluntarily returned the questionnaires from 27.8% to 38.1%, 39.1%, and 49.3% consecutively. In addition, the average PLEASE scores also became higher from 65.7% to 68.8%, 71.6%, and 74.2% on RDU implementation. Drug labeling, including extended content labels, and patient information leaflets achieved the highest score (83.0-93.7%), because of the 2022 drug labeling circular. On the other hand, the provision of the essential tools to facilitate rational drug prescribing (57.9-68.4 %) and the RDU awareness creation to medical personnel and patients (65.1-70.2%) were the two least achieved topics. Cooperation and teamwork of medical personnel, policies, roles and support of hospital administrators, information technology supporting hospital services, attitudes of patients, and policies and supervision from regulatory agencies were revealed as important factors affecting the RDU implementation in private hospitals. These findings can be used for upscaling the nationwide private hospital RDU to have drug system standards, patient safety and reduce unnecessary drug costs.