การศึกษาปัญหายาเหลือใช้ในผู้ป่วยโรคเรื้อรังผ่านการเยี่ยมบ้าน: กรณีศึกษาชุมชนแห่งหนึ่งในกรุงเทพมหานคร Leftover Medications in Patients with Chronic Diseases from Home Health Care Visits: A Community Study in Bangkok

Abstract

Objective: To determine the extent of leftover medications, cause andmanagement in patients with chronic diseases in a community in Bangkok,Thailand. Method: This cross-sectional descriptive study recruited patientswith chronic diseases including hypertension, dyslipidemia, diabetes andcardiovascular disease in a community in Bangkok with a conveniencesampling method. Data collection was conducted by interview andobservation on patients’ medication use including kind and number ofmedications left, cause and management on their leftover medications,during July 1st and November 22nd, 2013. Medication prices used tocalculate costs were national average, reference, and negotiated prices, asappropriate. Results: Of 97 patients, leftover medications were found in 95of them (97.9%). A total of 11,096 leftover tablets were found with anestimated total cost of 37,237.69 bahts and an average of 383.89 bahts perpatient. Number of tablets left and associated cost were found the most indiabetes medications. Aspirin 81 mg tablet was reported by the mostnumber of patients (33 patients). Causes of leftover medications includedforgetting some dosing (28.9%), followed by over-prescription, intentionalholding some doses, dosage self-adjustment, no follow-up appointmentdate, and the patient’s belief, respectively. The majority of patientsmanaged their leftover medications by finishing the ones given earlier first(47.8%) followed by keeping, returning, sharing, and discarding themedications, respectively. Conclusion: Most patients with chronic diseasesin a community in Bangkok had leftover medications. They forgot takingmedications and tried to finish the ones given earlier.Keywords: leftover medications, chronic diseases, hypertension, diabetes,dyslipidemia, cardiovascular disease, management