การพัฒนาคุณภาพการให้บริการเภสัชกรรมทางไกลในผู้ป่วยโรคไตระยะเริ่มต้น ของโรงพยาบาลชุมชนในจังหวัดขอนแก่น

Abstract

The confluence of hospital congestion and the spread of the coronavirus disease (COVID-19) has resulted in compromised accessibility to healthcare services for patients with renal disorders. Consequently, the implementation of telepharmacy service may represent a strategy that could yield improved health outcomes for patients with renal diseases. This action research employs a systemic conceptual framework as a guideline for development within the pharmaceutical care process in adhering to professional standards. The aim is to enhance the quality of telepharmacy service for patients with early chronic kidney disease, comparing outcomes before and after implementation. The sample group comprises 259 individuals with early chronic kidney disease who sought treatment at a local community hospital, selected through a cluster random sampling method. The tool used in this study consists of the Telepharmacy VHV (Virtual Health Visit) system recording software, namely general information, medication usage behavior, satisfaction levels, medication-related issues, health product details, laboratory test results, potential patient cost savings, and a survey to gather feedback from healthcare providers. The working period was between January and September, 2023. Analyzed via both descriptive statistics and content analysis, the outcomes of addressing medication-related issues after receiving two telepharmacy services were assessed. It was found that patients had cooperated by following the recommendations of pharmacists and were able to actively participate in addressing medication-related issues at a rate of 79.49%. The results concerning the human aspect reveal that overall satisfaction is at a high level ( = 4.85, S.D. = 0.37). The clinical outcomes reveal that, following the service, there is a statistically significant decrease in the average blood sugar level (p < 0.001), a statistically significant reduction in the average systolic blood pressure (p < 0.002), and a non-significant statistical difference in the average estimated glomerular filtration rate (eGFR) at level 2, indicating abnormal kidney function. The economic results indicate potential cost savings of up to 285,159 Baht. Therefore, providing telepharmacy service for kidney disease helps those patients in terms of delaying illness deterioration, reducing medication-related issues, minimizing the consumption of hazardous products, and enhancing collaboration in medication adherence, thereby achieving treatment goals effectively.