Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network

Lack of access to child-appropriate medicines results in off-label use. This study aimed to explore medicine management for paediatric patients and to highlight the challenges of the healthcare system under the universal health coverage of Thailand. Semi-structured interviews were conducted with 35...

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Main Authors: Rangsan Daojorn, Puckwipa Suwannaprom, Siritree Suttajit, Penkarn Kanjanarat, Prangtong Tiengket, Marc Lallemant
Format: Article
Language:English
Published: MDPI AG 2022-04-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/9/4/552
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author Rangsan Daojorn
Puckwipa Suwannaprom
Siritree Suttajit
Penkarn Kanjanarat
Prangtong Tiengket
Marc Lallemant
author_facet Rangsan Daojorn
Puckwipa Suwannaprom
Siritree Suttajit
Penkarn Kanjanarat
Prangtong Tiengket
Marc Lallemant
author_sort Rangsan Daojorn
collection DOAJ
description Lack of access to child-appropriate medicines results in off-label use. This study aimed to explore medicine management for paediatric patients and to highlight the challenges of the healthcare system under the universal health coverage of Thailand. Semi-structured interviews were conducted with 35 healthcare practitioners working in the public hospital network of Chiang Mai province from February to September 2020. Participants were asked about their experiences in managing the medicine supply for children. Findings revealed that paediatric patients had limited access to age-appropriate medicines. Children’s medicines are rarely selected for inclusion into hospital formularies because of constraining regulations and limited budgets. Additionally, child-appropriate formulations are unavailable on the market. Pharmaceutical compounding is unavoidable. Prepared products are provided weekly or monthly because of product stability concerns. Often, tablets are dispensed, and caregivers are instructed to cut up a tablet and disperse it in syrup in order to obtain a smaller dose in a dosage form appropriate for children to use at home. Without systematic support, access to safe and quality medicines for children is limited.
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spelling doaj.art-569ce632a4484c69a65e3195d21da2002023-12-01T01:19:44ZengMDPI AGChildren2227-90672022-04-019455210.3390/children9040552Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital NetworkRangsan Daojorn0Puckwipa Suwannaprom1Siritree Suttajit2Penkarn Kanjanarat3Prangtong Tiengket4Marc Lallemant5Health and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, ThailandHealth and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, ThailandHealth and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, ThailandHealth and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, ThailandPublic Health Promotion, Research and Training Foundation, Chiang Mai 50000, ThailandPublic Health Promotion, Research and Training Foundation, Chiang Mai 50000, ThailandLack of access to child-appropriate medicines results in off-label use. This study aimed to explore medicine management for paediatric patients and to highlight the challenges of the healthcare system under the universal health coverage of Thailand. Semi-structured interviews were conducted with 35 healthcare practitioners working in the public hospital network of Chiang Mai province from February to September 2020. Participants were asked about their experiences in managing the medicine supply for children. Findings revealed that paediatric patients had limited access to age-appropriate medicines. Children’s medicines are rarely selected for inclusion into hospital formularies because of constraining regulations and limited budgets. Additionally, child-appropriate formulations are unavailable on the market. Pharmaceutical compounding is unavoidable. Prepared products are provided weekly or monthly because of product stability concerns. Often, tablets are dispensed, and caregivers are instructed to cut up a tablet and disperse it in syrup in order to obtain a smaller dose in a dosage form appropriate for children to use at home. Without systematic support, access to safe and quality medicines for children is limited.https://www.mdpi.com/2227-9067/9/4/552accessibilitymedicinechildrenhealth systemmedicine management
spellingShingle Rangsan Daojorn
Puckwipa Suwannaprom
Siritree Suttajit
Penkarn Kanjanarat
Prangtong Tiengket
Marc Lallemant
Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network
Children
accessibility
medicine
children
health system
medicine management
title Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network
title_full Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network
title_fullStr Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network
title_full_unstemmed Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network
title_short Systems Challenges in Accessing Medicines among Children under Thailand’s Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network
title_sort systems challenges in accessing medicines among children under thailand s universal health coverage a qualitative study of a provincial public hospital network
topic accessibility
medicine
children
health system
medicine management
url https://www.mdpi.com/2227-9067/9/4/552
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