Development of a Computer Warning System to Promote Rational Drug Use by Using Andrographis paniculata as an Alternative Herb to Reduce Antibiotic Prescribing in Laemchabang Hospital.

Abstract

This action research aimed to develop a computer-based alert system to promote rational drug use by utilizing Andrographis paniculata as an alternative herbal medicine to reduce antibiotic prescribing at Laemchabang Hospital in two target disease groups under the RDU Service Plan policy: upper respiratory tract infections and mild acute diarrhea. The study sample consisted of outpatients seen during the pre- and post-intervention periods of three months each, for a total of 7,183 patients, comprising 5,523 with upper respiratory tract infections and 1,660 with acute diarrhea. Data were analyzed using the Chi-square test with a statistical significance level of 0.05. The results showed that following implementation of the alert system, the antibiotic prescribing rate in patients with upper respiratory tract infections decreased significantly from 22.54% to 13.15%, meeting the RDU target criterion (Odds ratio = 0.52, 95%CI = 0.45–0.60, p < 0.001). In acute diarrhea, the rate decreased significantly from 32.44% to 27.94% (Odds ratio = 0.81, 95%CI = 0.66–0.98, p = 0.035), although this did not yet meet the RDU target of 20%. The proportion of antibiotic drug costs relative to total drug expenditure also decreased significantly in both disease groups, and the use of Andrographis paniculata increased significantly from 0.88% to 2.58% (Odds ratio = 2.65, 95%CI = 1.75–4.01, p < 0.001). The computer-based alert system served as an effective tool for promoting rational drug use. It reduced unnecessary antibiotic prescribing, lowered hospital drug expenditure, and supported the use of herbal medicines listed in the National List of Essential Medicines.