Comparison of treatments for upper respiratory tract infections recommended in community pharmacies and hospitals in North East Thailand.

Comparative treatments for URTIs in terms of drug therapies, cost and outcomes were evaluated in community pharmacies and hospitals in Mahasarakham province, NE Thailand. A total of 1052 URTI patients was studied, 536 patients in two hospitals (H) where physicians diagnosed and prescribed and 516 patients in ten pharmacies, seven of which had pharmacists with no extra training (PNET) and three pharmacists with extra training (PET). Patient medication records and interview questionnaires were completed. A total of 388 patients (36.9%) reported their outcomes by postcard. Patients’ most common symptoms were cough (73%), fever (65%), sore throat (63%) and runny nose (58%). The most common symptom classifications were acute URTI (39%), cold (33%) and pharyngitis (17%). Most URTI patients attending the hospitals were dispensed antibiotics (86%) and analgesic (82%). In the pharmacies 67% of patients received antibiotics (74.1% by PNET pharmacists and 50.8% by PET pharmacists). Amoxicillin was dispensed to 77.6% and 50.4% of patients from hospitals and pharmacies respectively. In pharmacies 64% of medicines supplied were combinations which comprised analgesics, antihistamines, decongestants and cough suppressants. Generally only 2-3 days medicine was supplied through pharmacies but 7 days through hospitals. Antibiotics were supplied for 5.6 days at H, 3.6 days at PET pharmacies, and 2.1 days at PNET pharmacies. Drug therapy problems were found in 23.7% of H patients, 24% of PET patients, and 48.9% of PNET patients. Inappropriate or unsafe drug use was least in PET pharmacies whilst ineffective drug usage was least in the hospitals. Clinical outcomes of treatments and the health status after treatment in the 3 locations were not different. There were different humanistic outcomes with patients indicating greater satisfaction with the pharmacies in terms of convenience, time spent, and advice given and the last aspect was greatest for the PET pharmacists. Medicine costs in the hospitals were double those of the pharmacies (average 106 baht and 47 baht respectively) (p<0.001). The Phase II investigation was undertaken to overcome a methodological weakness in assessing patient satisfaction when only 36.9% responded to the postal questionnaire in the main study (Phase I). Twelve volunteer real patients with acute URTI symptoms visited and assessed treatment from all the twelve treatment facilities (144 individual consultations). Drug therapies were found to be similar to the main study. PET pharmacists asked questions and gave advice more often than physicians and PNET pharmacists. The greatest patient satisfaction was for the PET pharmacists in all aspects of satisfaction. It can be concluded that with further relevant training, such as the PharmD programme, community pharmacists in NE Thailand could provide an effective primary health care service for common diseases, such as URTIs, together with a high level of patient satisfaction.

Author dc:creator

• Osiri, Sunantha

Advisor dc:contributor.advisor

• R.M.E. Richards, D. McCaig and C.A. Mackie

• Upper respiratory tract infections (URTIs)
• Antibiotic prescribing
• Community pharmacy practice
• Pharmacist training
• Patient satisfaction
• Health care costs

Language dc:language

en

Identifier

oai:rgu-repository.worktribe.com:2807513
https://doi.org/10.48526/rgu-wt-2807513

OAI identifier oai:identifier

oai:rgu-repository.worktribe.com:2807513