Thai Bulletin of Pharmaceutical Sciences

EFFECTS OF DEVELOPING A MEDICATION ERROR AND ADVERSE DRUG EVENT REPORTING SYSTEM AT LAMPANG HOSPITAL

2025-07-01T14:01:20+07:00

This longitudinal study aimed to investigate the rate of medication error reporting and to assess the accuracy of medication error reports occurring in Lampang Hospital. Data collection was divided into two periods based on the implementation of the online reporting system: before system development, when reports were submitted via Google Sheets (October 2021 – September 2022), and after system development, when reports were submitted via Google Forms (October 2022 – September 2023). A report was considered accurate if it included complete information in three aspects: the medication use process, type of error, and severity. Results showed that the rates of medication error reporting before and after the system development were 43.15% (4,059 reports) and 56.85% (5,348 reports), respectively. The proportion of accurate reports was 92.53% (1,436/1,552 reports) and 91.23% (2,642/2,896 reports), respectively. The accuracy rate of reports made by pharmacists increased (92.25% and 93.48%; p = 0.177), whereas the accuracy rate of reports from pharmacy technicians significantly decreased (100.0% and 88.02%; p = 0.006). The medication use processes with the highest incidence of reported errors before and after system development were prescribing (64.50% and 60.02%, respectively) and pre-dispensing errors (23.87% and 30.70%, respectively). This study demonstrates that the medication error reporting system via Google Forms increased both the reporting rate and the accuracy of reports by pharmacists. Enhancing reporting system efficiency should consider the engagement of all stakeholders, improvement of understanding of the reporting system and terminology, and development of feedback mechanisms for reporters to further promote medication safety within the hospital.

KNOWLEDGE OPINIONS LEGAL ENFORCEMENT AND FACTORS RELATED TO LEGAL ENFORCEMENT OF MEDICAL FACILITIES ACT AMONG REGULATORY OFFICERS IN PROVINCIAL HEALTH OFFICES

2025-08-18T07:38:33+07:00

This cross-sectional analytical study aimed to assess the knowledge, opinions, law enforcement practices, and associated factors related to the enforcement of the Medical Facilities Act among regulatory officers in provincial areas. The study population comprised officers responsible for the supervision and regulation of medical facilities within the Consumer Protection and Public Health Pharmacy Division at the Provincial Public Health Offices in all 76 provinces across Thailand (one officer per province). Data were collected via mailed questionnaires during July–August 2024, with a total of 70 responses received, yielding a response rate of 92.11%. Data were analyzed using descriptive statistics, chi-square tests, and Fisher’s exact tests at a significance level of 0.05. The results showed that most officers had a moderate level of knowledge (60.0%) and expressed a high level of agreement (98.6%) with key decision-making factors in law enforcement, particularly the offender’s intent, business size, and prior offenses (98.6%, 95.7%, 92.9% respectively). Opinions regarding the administrative fine mechanism were at a moderate level (51.4%). Law enforcement practices were found to be high in the areas of inspection, seizure, and prosecution (100.0%, 80.0%, 80.0% respectively), whereas the application of the administrative fine mechanism remained limited (41.4%). Further analysis revealed that the level of knowledge among officers was the only factor significantly associated with the overall level of law enforcement (p-value = 0.004). Therefore, it is necessary to continuously promote and develop legal knowledge, both theoretical and practical, among regulatory officers, and to establish clear, comprehensive, and systematic enforcement guidelines to strengthen the efficiency of medical facility regulation at the provincial level.

OUTCOMES OF DEVELOPING A LINE OFFICIAL ACCOUNT USING DESIGN THINKING FOR PHARMACEUTICAL CARE IN CANCER PATIENTS AT LAMPANG HOSPITAL

2025-09-12T15:56:19+07:00

Cancer patients receiving chemotherapy may experience adverse effects that impact their quality of life. This study utilized information technology through a verified LINE application account, applying a design-thinking approach to enhance the role of pharmacists in providing education and monitoring pharmaceutical care. Thus, the objective of this study was to evaluate the effectiveness of the development of the Oncology LPH LINE official account. This development study was conducted in three phases: 1) gathering requirements and developing the initial application, 2) testing and refining based on satisfaction surveys (full score of 5) and System Usability Scale (SUS) questionnaires (full score of 100), and 3) monitoring the outcomes of pharmaceutical care delivery. The results showed the overall satisfaction from the sample group with the final version of the LINE official account, Oncology LPH version 3, was the highest, with an average satisfaction score of 4.7 ± 0.4. The SUS score was 90.7. The most frequently accessed Rich Menu among participants was the educational information about adverse effects, with a total of 897 visits (67.6%). The most common reason participants contacted pharmacists was for dietary inquiries, accounting for 60 instances (29.1%). Regarding the assessment of adverse events from pharmaceutical care based on CTCAE version 5.0, most patients experienced mild symptoms (grades 1–2), accounting for 112 individuals (93.3%). The most observed symptom was peripheral numbness in the hands and feet (70.0%). In summary, the Oncology LPH LINE official account, when combined with pharmacist support, demonstrates strong potential in enhancing pharmaceutical care for cancer patients by improving knowledge, fostering patient engagement, and facilitating the monitoring and management of adverse effects.

WASTE ANALYSIS IN IN-PATIENT PHARMACEUTICAL DISPENSING SYSTEM BY LED GUIDE AND CONVEYOR BELT: AN APPLYING FROM DATA MINING TECHNIQUES

2025-10-22T08:17:10+07:00

Maharaj Nakhon Chiang Mai University Hospital implemented a daily dose medication distribution system with an automated conveyor for safe and effective medication management. However, delays during peak hours and medication errors have been observed. To identify waste in the medication distribution process and analyze frequently co-prescribed medications using data mining and association rule techniques to suggest improvements. A quantitative analysis of prescription data from April 1, 2022, to March 31, 2023, used process flow mapping and WASTE analysis. Data mining and association rule discovery in RapidMiner Studio analyzed co-prescribed medications, identifying associations among pairs, triples, and quadruples. Key statistical measures, including support, confidence, and lift, were calculated. The study analyzed seven zones of medication cabinets, focusing on a conveyor belt that completes a rotation in 84 seconds and has five ejection stations. On average, 1,853 medication orders are processed daily, with 1,391 entering through the guided cabinets and conveyor. The study used Frequent Pattern Growth to identify 151 co-prescription rules and found high error rates, mainly under-prescribed quantities, in Zone EL2 (injectable medicine). It also showed all eight wastes of DOWNTIME, including defects in error reports and overproduction from pre-packaging excess medications. By managing these issues, we can reduce waste linked to wait times and unnecessary movement by staff refilling medications in short supply. This enables staff to focus on other important tasks. Additionally, transportation and extra processing waste can be recognized through unnecessary ejections. The study identified eight types of waste in the pharmaceutical dispensing system and emphasized the need for continuous quality improvement based on lean principles to reduce waste and enhance efficiency. By optimizing storage, workflow, and staffing, as well as recognizing commonly co-prescribed medications, the process can be better organized. Using data analysis is essential for managing medications more effectively and minimizing medication errors.

FACTORS ASSOCIATED WITH PREVENTABLE SEVERE EXTRAPYRAMIDAL SYMPTOMS FROM ANTIPSYCHOTIC USE IDENTIFIED USING BENZTROPINE AS A TRIGGER TOOL

2025-10-15T18:46:00+07:00

Preventable adverse drug events (ADEs) are critical targets for detection to ensure patient safety. This study aimed to evaluate factors associated with the occurrence of preventable ADEs among patients receiving benztropine, used as a trigger tool for monitoring severe extrapyramidal symptoms in patients treated with antipsychotics. A retrospective study was conducted by reviewing patient medical records at Saraburi Hospital. The population comprised all patients who received benztropine at Saraburi Hospital between October 1, 2021, and September 30, 2024. The sample included those who met the inclusion criteria of receiving antipsychotics and assessing ADEs, excluding cases with incomplete, abnormal, or implausible data. Collected data included patient demographic characteristics and clinical data. Data were analyzed using descriptive statistics, and the associations between variables were examined using the chi-square test or fisher’s exact test, as appropriate. Subsequently, univariate binary logistic regression was performed to assess the factors affected with the occurrence of preventable and non-preventable ADEs. The univariate analysis of 62 patients, of whom 38 experienced preventable ADEs, most factors were not significantly associated with the occurrence of preventable ADEs. However, the duration of antipsychotic use showed a statistically significant association with the occurrence of preventable ADEs (p-value = 0.017). Patients who had received antipsychotic treatment for more than 4 months were approximately 5.83 times more likely to experience preventable ADEs compared with those who had received treatment for 4 months or less (OR = 5.833). The findings indicated that prolonged use of antipsychotics for more than 4 months was associated with preventable ADEs. Therefore, regular monitoring and risk assessment should be implemented, along with the development of pharmacovigilance systems, to prevent such events in this patient group.

DEVELOPMENT OF A TELEPHARMACY SERVICE SYSTEM FOR PHARMACEUTICAL CARE IN HYPERTENSIVE AND DIABETIC PATIENTS RECEIVING HOME WARD CARE AT KLONGLUANG HOSPITAL, PATHUM THANI

2025-11-26T08:22:20+07:00

This mixed-methods study aimed to develop and evaluate the effectiveness of a telepharmacy service system for patients with diabetes or hypertension receiving home ward care. The system comprised four key components: (1) service structure, (2) multidisciplinary team workflow with clearly defined roles for each team member, (3) communication channels between the team and patients via a Line Official Account and the “Mor Prom” application, and (4) telepharmacy care activities, including medication reconciliation, adherence monitoring, drug-related problem management, and individual medication counseling, are continuously provided from admission to one month after discharge. The study was conducted in three phases: Phase 1 involved a situational analysis and system design through focus group discussions with 15 medical staff. Phase 2 implemented the system among patients with diabetes or hypertension receiving home ward care between March and May 2025, covering two patient cycles (a total of 87 patients). Clinical outcomes and user feedback were collected during this phase. Phase 3 focused on evaluation and lessons learned through interviews with the same 15 medical staff and 7 pharmacists. The project was conducted from October 2024 to August 2025. The results showed statistically significant improvements in clinical and behavioral outcomes. The blood pressure decreased (p < 0.05) from 153/84 mmHg to 136/80 mmHg, and the blood glucose level declined (p < 0.05) from 311.19 mg/dl to 165.38 mg/dl. Medication adherence, measured by pill count, increased (p < 0.05) from 77.22% to 89.94%, and the MTB-Thai questionnaire score improved (p < 0.05) from 20 to 23 (out of 24). The number of patients with drug-related problems decreased (p < 0.05) from 48 to 21. The satisfaction score was 4.74 (out of 5). In conclusion, the telepharmacy service system for pharmaceutical care effectively enhanced clinical outcomes, medication adherence, and patient satisfaction, while reducing drug-related problems.