Development of a Medication Management System for Palliative care Patients in a Palliative Care Facility Udonthani hospital

Abstract

This action research aimed to develop a medication management system and evaluate outcomes in drug-related problems, clinical outcomes, and quality of life among palliative care patients at a palliative care facility. The study was conducted from March to June 2025 at the Phutthabut Suanweluwan Palliative Care facility, Chiang Yuen Subdistrict, Udon Thani Province, Thailand. A total of 24 palliative care patients participated in the study. Data were collected using the Edmonton Symptom Assessment System (ESAS), a drug-related problems (DRPs) recording form, and the Thai version of the Palliative Care Outcome Scale (POS). Statistical analyses included percentage, frequency, mean, standard deviation, and paired t-test.

Results: Most patients were male (58.33%) and aged over 60 years (79.17%). The top three primary diagnoses were stroke (20.83%), dementia (16.67%), and hepatocellular carcinoma (12.50%). Drug-related problems were identified in 17 patients (70.83%). The three most common DRPs included: medication non-compliance (33.33%), inappropriate dosing frequency (22.22%), and subtherapeutic dosage (16.67%), leading to treatment ineffectiveness (50.00%) and adverse drug reactions (22.22%). Interventions included use of a medication calendar, medication counseling, verification of administration techniques, medication reconciliation, storage of medications in medicine bag, and the use of educational materials. Comparisons of clinical outcomes before and 72 hours after pharmaceutical care showed statistically significant improvement in symptoms, including pain, fatigue, nausea, depression, anxiety, drowsiness, anorexia, overall well-being, and dyspnea (p < 0.001 for all symptoms). Quality of life significantly improved, with the mean POS score decreasing from 6.54 (SD = 5.03) before intervention to 2.91 (SD = 6.08) after intervention (p < 0.001), indicating a higher level of patient quality of life.

Conclusion: Pharmaceutical care interventions, including the use of a medication calendar, significantly improved both clinical outcomes and quality of life among palliative care patients in a palliative care facility.