การพัฒนาระบบการจัดเก็บและสำรองยาในหน่วยบริการ ปฐมภูมิในเขตอำเภอแม่ระมาด จังหวัดตาก

Abstract

The objectives of this study were to 1) evaluate the medication storage and inventory control situations at primary care units in Maeramad district, Tak province, 2) explore problems and barriers regarding medication storage and inventory control at the primary care units in the officers’ perspective, 3) search for a of medication storage and inventory control guideline from the agreement between pharmacists and the primary care officers, and 4) evaluation the program after implementing the new guideline for medication storage and inventory control system for the primary care units in Maeramad district. The study participants were officers who were responsible for medication storage and inventory control at primary care units in Maeramad district. This study used both qualitative and quantitative methods. In phase I, a descriptive study was used for assessing medication storage and inventory control situations in the primary care units and the barriers to meet the standards by using in-depth interviews and observation. In phase II, the guideline for medication storage and inventory control for the primary care units in Maeramad district was developed by using the focus group discussion among the primary care offices. In phase III, after implementing the new guideline, the evaluation was conducted by using quasi-experimental design comparing the before and after scores among the poor performance units (gaining less than 80.0 points.) Qualitative data was analyzed by using content analysis. Quantitative data was analyzed by descriptive statistics and Wilcoxon’s signed rank test. The results showed that the mean score for the medication storage and inventory control performance at the primary care units was at 77.1%. The mean score for medication storage was at 74.2% and for inventory control was at 82.5%. After conducting the in-depth interviews with the participants, the findings showed that the major medication storage problems were the limited space, unsecured storage, poor ventilation, too hot temperature, and irregular temperature control in the storage. The major inventory control problems were no stock card, incorrect and out-dated records, and more than 3-month inventory control rate. The group developed the new guideline for supporting the medication storage and inventory control in primary care units. A new standard guideline for medication storage and inventory control, working forms and protocols for medication stock control appropriated for Maeramad context were established in the new guideline. The pharmacist at Maeramad Hospital served as a facilitator and supported the equipment, tools and technical information. After implementing the new system and guidelines, the performance scores were significantly higher than the pre-test scores at 95% confidence level.