Effectiveness of rational drug use management system in Lampang Hospital in order to become RDU-Hospital.

Abstract

For fiscal years 2022–2026, the Ministry of Public Health established 12 RDU-Hospital indicators. Achieving at least 10 indicators qualifies a facility for RDU-Hospital certification, whereas in primary care both indicators must be met for RDU-Primary Care certification. This study aimed to strengthen RDU implementation at Lampang Hospital through knowledge management and systems management to attain RDU-Hospital certification. An action research design was employed. Retrospective patient data from Lampang Hospital and affiliated primary care units (PCUs; Subdistrict Health Promoting Hospitals) were collected from October 2021 to September 2022. Twelve RDU-Hospital indicators were assessed across three four-month phases. Each phase comprised five steps: data collection, indicator monitoring, root-cause analysis, intervention implementation, and results analysis. Data were analyzed using descriptive statistics and the chi-square test. The results indicate that implementing knowledge management and systems management, supported by the development of a clinical decision support system (CDSS), enabled Lampang Hospital to meet 10 of the 12 RDU-Hospital indicators. Additionally, 92.6% of PCUs in the network met both RDU-Primary Care indicators. The rate of antibiotic use for upper respiratory tract infections (URTI) decreased from 30.9% to 1.9% (p < 0.001), and for acute diarrhea from 33.2% to 26.1% (p < 0.001). Furthermore, the use of metformin among patients with type 2 diabetes increased from 73.1% to 93.2% (p < 0.001). In conclusion, knowledge management combined with systems-based RDU management effectively promoted rational medicine use, improved patient safety, and enabled Lampang Hospital to achieve the RDU-Hospital standard set by the Ministry of Public Health.