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...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2022-04-01
|
Series: | Children |
Subjects: | |
Online Access: | https://www.mdpi.com/2227-9067/9/4/552 |
_version_ | 1797436263877312512 |
---|---|
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. |
first_indexed | 2024-03-09T11:00:05Z |
format | Article |
id | doaj.art-569ce632a4484c69a65e3195d21da200 |
institution | Directory Open Access Journal |
issn | 2227-9067 |
language | English |
last_indexed | 2024-03-09T11:00:05Z |
publishDate | 2022-04-01 |
publisher | MDPI AG |
record_format | Article |
series | Children |
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 |
work_keys_str_mv | AT rangsandaojorn systemschallengesinaccessingmedicinesamongchildrenunderthailandsuniversalhealthcoverageaqualitativestudyofaprovincialpublichospitalnetwork AT puckwipasuwannaprom systemschallengesinaccessingmedicinesamongchildrenunderthailandsuniversalhealthcoverageaqualitativestudyofaprovincialpublichospitalnetwork AT siritreesuttajit systemschallengesinaccessingmedicinesamongchildrenunderthailandsuniversalhealthcoverageaqualitativestudyofaprovincialpublichospitalnetwork AT penkarnkanjanarat systemschallengesinaccessingmedicinesamongchildrenunderthailandsuniversalhealthcoverageaqualitativestudyofaprovincialpublichospitalnetwork AT prangtongtiengket systemschallengesinaccessingmedicinesamongchildrenunderthailandsuniversalhealthcoverageaqualitativestudyofaprovincialpublichospitalnetwork AT marclallemant systemschallengesinaccessingmedicinesamongchildrenunderthailandsuniversalhealthcoverageaqualitativestudyofaprovincialpublichospitalnetwork |