Intahphuak Sophaphan, Lorga Thaworn, Tipwareerom Worawan
School of Nursing, Mae Fah Luang University, Chiang Rai 57100, Thailand.
Faculty of Nursing, Chiang Rai Rajabhat University, Chiang Rai 57100, Thailand.
Trop Med Infect Dis. 2022 Oct 16;7(10):304. doi: 10.3390/tropicalmed7100304.
To address the problems related to drug resistance and medication safety, the rational drug use (RDU) policy has been implemented in Thailand since 2014. Theoretically, the policy was supposed to bring drastic changes to the way clinicians prescribe medications and its impacts on clinical practice, however, it has not yet been investigated. The study aimed to describe the experience of community health nurses with regard to the impact of RDU policy implementation on their practices.
Focus group interviews and in-depth interviews with community nurses were conducted. Thematic analysis was performed.
Five themes emerged from the analysis, namely, (1) a welcome opportunity, (2) RDU as the quality of healthcare, (3) multidisciplinary collaboration, (4) reinventing productive interactions between nurses and patients, and (5) challenges over control of medications prescribed or purchased elsewhere.
Implementing RDU in primary care provides opportunities for protecting individual patients and public health as well as safeguarding against professional prescription error. This can be made possible by adopting a systemic approach to changes. Additional educational and organizational support will optimize health professionals' contribution to the implementation and hence optimal outcomes of this important policy.
为解决与耐药性和用药安全相关的问题，泰国自2014年起实施合理用药（RDU）政策。从理论上讲，该政策本应给临床医生的用药处方方式及其对临床实践的影响带来巨大变革，然而，目前尚未对此进行调查研究。本研究旨在描述社区卫生护士对RDU政策实施对其工作实践影响的体验。
对社区护士进行焦点小组访谈和深入访谈，并进行主题分析。
分析得出五个主题，即：（1）一个受欢迎的机遇；（2）将合理用药视为医疗保健质量；（3）多学科协作；（4）重塑护士与患者之间富有成效的互动；（5）在控制在其他地方开具或购买的药物方面面临的挑战。
在初级保健中实施合理用药为保护个体患者和公众健康以及防范专业处方错误提供了机会。通过采取系统性的变革方法可以实现这一点。额外的教育和组织支持将优化卫生专业人员对该政策实施的贡献，从而实现这一重要政策的最佳效果。
