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- PublicationImplementation and Evaluation of Pharmaceutical Care Service for Refill Clinic at Ramathibodi Hospital(2009) Orapun Sripathomsawatdi; Petcharat Pongcharoensuk; Vijj Kasemsup; อรพรรณ ศรีปฐมสวัสดิ์; เพชรรัตน์ พงษ์เจริญสุข; วิชช์ เกษมทรัพย์; Mettapracharak (Wat Rai Khing) Hospital. Department of Pharmacy; Mahidol University. Faculty of Pharmacy. Department of Pharmacy; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Community MedicineA pharmaceutical care service (PCS) was initiated at refill clinic, Ramathibodi Hospital. The objective of this study was to implement and evaluate PCS program using Donabedian's (Structure-Process-Outcome) conceptualization. The study was divided into 4 phases; 1) project initiation, 2) preparation, 3) implementation, and 4) program assessment. The project was approved in March 2007. In the preparation phase, all structures, work place, facilities (such as computer software), pharmacists, and work process were planned for the provision of PCS. During the one-year implementation phase (July 2007 to June 2008), a total of 2,155 patients with chronic diseases and stable condition were recruited to receive PCS together with refill prescribing process. The pharmacists recorded prescription data, provided pharmaceutical care services to 2,809 encounters, and gave 3,345 refill prescriptions. Between October 2007 and June 2008, 1,545 of the 2,548 encounters (60.64%) were returned for refills. Of these, 1,111 encounters (71.91%) were refilled with PCS process. For clinical outcomes, pharmacists interviewed 154 patients and identified 72 DTPs, 61.11% of which were non-compliance. When interventions are recommended for the problems, physicians accepted 86.36% of pharmacists' recommendations. For economic outcomes, benefit as drug cost saving (from duplicates and oversupplies) was 419,214.48 Baht and the benefit to cost ratio was 2.45 : 1. For humanistic outcomes, 95.2% of the respondents recommended their relatives or friends with problems or doubts about medication to receive PCS. In conclusion, PCS could reduce DRPs and save drug cost. It is recommended that the program should be expanded to cover other groups of patients so as to achieve more efficient use of health resources.
- PublicationOverviews of Data Mining in Hospital Information System(2009) Oraluck Pattanaprateep; Petcharat Pongcharoensuk; Sming Kaojarern; อรลักษณ์ พัฒนาประทีป; เพชรรัตน์ พงษ์เจริญสุข; สมิง เก่าเจริญ; Mahidol University. Faculty of Pharmacy. Department of Pharmacy; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of MedicineHospital information system captures huge data in each hospital database, but currently few knowledge is produced because of its complexity. Data mining has great potential for exploring the hidden patterns in complex data sets of the hospital information system. Introduction to data mining will provide hospital staff understand how data mining discovers and extracts useful patterns from this large data.
- PublicationEconomic evaluation of rotavirus vaccination: an important step of the introduction to the national immunization program in Thailand(2021) Onwipa Rochanathimoke; Arthorn Riewpaiboon; Naiyana Praditsitthikorn; Piyanit Tharmaphornpilas; Suchada Jiamsiri; Montarat Thavorncharoensap; Postmac, Maarten J.Introduction World Health Organization recommends rotavirus vaccine for all national immunization programs (NIPs). To provide country-specific evidence, we conducted economic evaluation of a monovalent rotavirus vaccination using specific data of the pilot phase in Thailand. Method A Markov model was adopted to compare the 2020 birth cohort once receiving rotavirus vaccination versus no vaccination from healthcare and societal perspective over five years. Data on disease burden, vaccine effectiveness, costs, and utilities were taken from a cohort study in two provinces of Thailand. Sensitivity analyses were performed to test the robustness of the results. Results Rotavirus vaccination would reduce rotavirus diarrhea and costs of illness by 48% and 71%, respectively, over the first five years of life. At USD 13 per dose, vaccine was cost-effective with the ICERs of USD 4,114 and USD 1,571per QALY gained from healthcare and societal perspective, respectively. Results were sensitive to incidence and vaccine cost. The budget for vaccine purchasing was estimated at USD13 million per year. Conclusion Incorporating rotavirus vaccination into the NIP substantially reduced health and cost outcomes and was cost-effective for both perspectives. However, the government needs to negotiate vaccine price prior to program implementation to achieve favorable budget impact.
- PublicationEconomic burden of rotavirus diarrhea in Thailand: Report from a pilot study on rotavirus vaccination(2019) Onwipa Rochanathimoke; Arthorn Riewpaiboon; Piyanit Tharmaphornpilas; Suchada Jiamsiri; Montarat Thavorncharoensap; Postma, Maarten J.; Mahidol University. Faculty of Pharmacy. Division of Social and Administrative Pharmacy; Ministry of Public Health. Department of Disease Control; Groningen Research Institute of Pharmacy (GRIP). University of Groningen. Unit of PharmacoTherapy, -Epidemiology & -Economics; University Medical Center Groningen. University of Groningen. Department of Health Sciences; University of Groningen. Faculty of Economics & Business. Department of Economics, Econometrics & FinanceBackground: Rotavirus diarrhea is the leading cause of morbidity and mortality in young children in both developed and developing countries. Hospitalization costs are a significant burden of both governments and households. The objective of this study was to estimate the economic burden associated with the hospitalization of children with non-rotavirus and rotavirus diarrhea in two provinces in Thailand. Method: A prospective incidence-based cost-of-illness study was conducted on children under five years old with acute diarrhea who had been admitted to public hospitals in two provinces during October 2012 and June 2013. Caregivers were interviewed to estimate costs from a societal perspective at 2014 values. Stool samples were examined for rotavirus antigens. Multivariate regression analysis was used to assess the relationship of predictor variables to costs. Annual economic burden of rotavirus hospitalization was estimated by multiplying the number of hospitalized children and the hospitalization cost per episode. The costs were converted to international dollars (I$) using purchasing power parity (PPP) (1 USD = 12.36 baht for the year 2014). Results: Seven hundred and eighty-eight cases of acute diarrhea were included in the analysis. Of the total, one hundred and ninety-seven (25%) were detected as being rotavirus positive. Total societal costs of inpatient care per episode were 822.68 USD (10,165 Baht). The average costs of children with and without rotavirus were 903.39 USD (11,162 Baht) and 795.40 USD (9,827 Baht), respectively. Based on the multiple regression analysis, rotavirus infection, severity, and younger age were significantly associated with the higher costs. Conclusion: Diarrhea, rotavirus diarrhea in particular, represents of a substantial economic burden in the society in Thailand. The accurate estimates that societal costs of the rotavirus diarrhea hospitalizations provide valuable input for considering a preventive program.
- PublicationEconomic analysis for evidence-based policy-making on a national immunization program: A case of rotavirus vaccine in Thailand(2012) Charung Muangchana; Arthorn Riewpaiboonb; Suchada Jiamsiri; Piyanit Thamapornpilas; Porpit Warinsatian; Ministry of Public Health. Department of Disease Control. National Vaccine Institute; Mahidol University. Faculty of Pharmacy. Division of Social and Administrative Pharmacy; Ministry of Public Health. Department of Disease Control. Bureau of Epidemiology; Ministry of Public Health. Department of Disease Control. Bureau of General Communicable DiseaseSevere diarrhea caused by rotavirus is a health problem worldwide, including Thailand. The World Health Organization has recommended incorporating rotavirus vaccination into national immunization programs. This policy has been implemented in several countries, but not in Thailand where the mortality rate is not high. This leads to the question of whether it would be cost-effective to implement such a policy. The Thai National Vaccine Committee, through the Immunization Practice Subcommittee, has conducted an economic analysis. Their study aimed to estimate the costs of rotavirus diarrhea and of a rotavirus vaccination program, and the cost-effectiveness of such a program including budget impact analysis. The study was designed as an economic evaluation, employing modeling technique in both provider and societal perspectives. A birth cohort of Thai children in 2009 was used in the analysis, with a 5-year time horizon. Costs were composed of cost of the illness and the vaccination program. Outcomes were measured in the form of lives saved and DALYs averted. Both costs and outcomes were discounted at 3%. The study found the discounted number of deaths to be 7.02 and 20.52 for vaccinated and unvaccinated cohorts, respectively (13.5 deaths averted). Discounted DALYs were 263.33 and 826.57 for vaccinated and unvaccinated cohorts, respectively (563.24 DALYs averted). Costs of rotavirus diarrhea in a societal perspective were US$6.6 million and US$21.0 million for vaccinated and unvaccinated cohorts, respectively. At base case, the costs per additional death averted were US$5.1 million and US$5.7 for 2-dose and 3-dose vaccines, respectively, in a societal perspective. Costs per additional DALYs averted were US$128,063 and US$142,144, respectively. In a societal perspective, with a cost-effectiveness threshold at 1 GDP per capita per DALYs averted, vaccine prices per dose were US$4.98 and US$3.32 for 2-dose and 3-dose vaccines, respectively; in a provider perspective, they were US$2.90 and US$1.93. One-way and probabilistic sensitivity analyses were included. The budget required for vaccine purchase was calculated for all scenarios.
- PublicationDrug management in Tambon health promoting hospitals: a systematic review(2015) Vanida Prasert; Farsai Chanjaruporn; วนิดา ประเสริฐ; ฟ้าใส จันท์จารุภรณ์; Mahidol University. Faculty of Pharmacy. Department of PharmacyTambon Health Promoting Hospitals (THPHs) are the first level of public health service system. Before the health service system reform, the THPHs confronted inefficient drug management. Presently, drug management in THPHs develops and expands responsibility to conform health system reformation in Thailand. This study aimed to systematically review the drug management in THPHs to know the current situation of drug management including the efficiency of drug management and patient satisfaction after the reform of the health service system. A literature search was conducted in the ThaiLIS and the Health Systems Research Institute databases during 2004 to 2015. Results revealed the sixteen articles which met the inclusion criteria. The six dimensions of drug management tasks in THPHs which were used as the criteria consist of drug system management, medical supply management, inventory management, pharmaceutical care, home care pharmacy services and rational drug use promotion. It was found that most THPHs performed efficiently for drug management thus patients satisfied for their services. Moreover, some THPHs performed inefficiently on medical supply and inventory management. The problems and obstacles also revealed inadequacy of the staff and budget. Therefore, government should focus on proper resource allocation and provide crucial supports to enhance efficiency and quality of treatment to the patients
- Publicationปัจจัยการตัดสินใจของนักศึกษาระดับปริญญาตรี ในการเข้าร่วมโครงการแลกเปลี่ยนนักศึกษา(2559) อัมพร สงคศิริ; Amporn Songkasiri; มหาวิทยาลัยมหิดล. คณะเภสัชศาสตร์การวิจัยครั้งนี้มีวัตถุประสงค์เพื่อศึกษาปัจจัยที่มีผลต่อการตัดสินใจของนักศึกษาระดับปริญญาตรี คณะเภสัชศาสตร์ มหาวิทยาลัยมหิดล ในการเข้าร่วมโครง การแลกเปลี่ยนนักศึกษา รวมทั้งศึกษาระดับความสำคัญของปัจจัยในโครงการแลกเปลี่ยนนักศึกษาที่มีผลต่อการตัดสินใจของนักศึกษา การวิจัยครั้งนี้เป็นการวิจัยประเภท Cross-sectional study โดยใช้วิธีการวิจัยแบบสำรวจ ประชากรที่ใช้ในการศึกษา คือ นักศึกษาระดับปริญญาตรีของคณะเภสัชสาสตร์ มหาวิทยาลัยมหิดลซึ่งกำลังศึกษาอยู่ในชั้นปีที่ 2 – 5 ในภาคการศึกษาที่ 1 ประจำปีการศึกษา 2557 จำนวน 466 คน โดยใช้แบบสอบถามซึ่งมีค่าความเชื่อมั่น 0.89 โดยเก็บข้อมูล ได้แก่ ข้อมูลทั่วไปของนักศึกษา และระดับความสำคัญของปัจจัยในโครงการแลกเปลี่ยนนักศึกษาที่มีผลต่อการตัดสินใจเข้าร่วมโครงการแลกเปลี่ยนนักศึกษาทั้งหมด 9 ด้าน ผู้วิจัยได้รับแบบสอบถามที่มีความสมบูรณ์จำนวนทั้งสิ้น 382 ชุด หรือคิดเป็นร้อยละ 82 ของประชากรที่ใช้ในการศึกษาทั้งหมด สำหรับนำไปวิเคราะห์ข้อมูลโดยใช้สถิติ ได้แก่ ค่าแจกแจงความถี่ ค่าร้อยละ ค่าเฉลี่ย ค่าเบี่ยงเบนมาตรฐาน ค่า t-test และ ค่า F-test ผลการวิจัยพบว่าปัจจัยด้านเจ้าหน้าที่ค่างชาติฯ (mean=4.46+0.5) ด้านค่าครองชีพ (mean=4.31+0.61) ด้านทุนสนับสนุน (mean=4.23+0.54) และด้านสถานที่พักและสภาพแวดล้อม (mean=4.22+0.48) มีผลต่อการตัดสินใจเข้าร่วมโครงการแลกเปลี่ยนนักศึกษาในระดับมากที่สุด นอกจากนี้พบว่า ปัจจัยส่วนบุคคลของนักศึกษา ได้แก่ เพศ ชั้นปีที่เรียน และศาสนาที่นักศึกษานับถือมีผลต่อการตัดสินใจเข้าร่วมโครงการแลกเปลี่ยนนักศึกษาที่ต่างกันอย่างมีนัยสำคัญทางสถิติ ในขณะที่อายุ เกรดเฉลี่ย และรายได้ของผู้ปกครองไม่มีผลต่อการตัดสินใจเข้าร่วมโครงการดังกล่าว ผลการวิจัยนี้ชี้ให้เห็นว่า นักศึกษาในภาพรวมให้ความสำคัญกับเรื่องการดูแลนักศึกษาโดยมหาวิทยาลัยคู่ความร่วมมือ ปัจจัยด้านการเงิน และสภาพแวดล้อมของสถานที่ ๆ จะเดินทางไป นอกจากนี้ การจัดการโครงการแลกเปลี่ยนอาจต้องคำนึงถึงปัจจัยส่วนบุคคลของนักศึกษาด้วย เนื่องจากนักศึกษาแต่ละกลุ่มอาจมีการตัดสินใจที่แตกต่างกัน
- PublicationEtlingera elatior Extract promotes cell death in B16 melanoma cells via down-regulation of ERK and Akt signaling pathways.(2017) Aungkana Krajarng; Malin Chulasiri; Ramida Watanapokasin; Mahidol University. Faculty of Pharmacy; Thammasat University. Chulabhorn International College of Medicine; Srinakharinwirot University. Faculty of Medicine. Department of BiochemistryBackground: Torch ginger (Etlingera elatior, EE) is a ginger plant that found in Southeast Asia. Previous study showed its flowers and leaves composed of several flavonoids with anti-cancer activity. This study aims to investigate the mechanism of EE extract on cell death induction in melanoma cells. Methods: To carry out this study, the cytotoxic effect of EE extract was performed using MTT assay. Nuclear morphological change and loss of mitochondrial membrane potential were observed using Hoechst 33,342 and JC-1 staining. Flow cytometry using Annexin V/PI double staining assessed apoptosis, necrosis and viability. Caspase activity was detected by caspase activity kits. The expression of Bcl-2 family proteins, ERK and Akt signaling pathways were examined by Western blot analysis. Results: The treatment of EE extract resulted in a dose- and time-dependent reduction in cell viability in B16 cells. It also induced nuclear condensation, phosphatidylserine exposure, and loss of mitochondrial membrane potential, which are markers of apoptosis. Furthermore, the expression of Bim was increased instead of Bax and Bcl-2. The results also showed caspase-independent activity and the down-regulation of ERK and Akt signaling pathway. Conclusion: The results suggest that EE extract induced caspase-independent cell death via down-regulation of ERK and Akt pathways in B16 cells. This may be beneficial as a chemopreventive or chemotherapeutic agent in melanoma treatment.
- PublicationMedicinal Plants in the Khok Pho District, Pattani Province (Thailand)(2005-12) Wongsatit Chuakul; Mahidol University. Faculty of Pharmacy. Department of Pharmaceutical BotanyA survey on utilization of medicinal plants by herbalists in Khok Pho District, Pattani Province, Thailand was carried out by interviewing herbalists, collecting and identifying the plant specimens, and also comparing the plant specimens with the authentic specimens at two herbaria, i.e. at the Bangkok Herbarium, Botany Section, Botany and Weed Science Division, Department of Agriculture, Ministry of Agriculture and Cooperatives and at the Forest Herbarium, National Park, Wildlife and Plant Conservation Department. Ninety-five medicinal plants belonging to fifty-seven families commonly used as medicinal plants are reported. Of these ninety-five species, fourteen species are newly recorded as medicinal plants. Thirty-nine species are used in combinations with other medicinal plants in a total of sixteen different preparations.
- PublicationMedicinal plants used in Kungkrabaen Royal Development Study Center, Chanthaburi province(2006-06) Wongsatit Chuakul; Noppamas Soonthornchareonnon; Sommai Sappakun; Wongsatit Chuakul; Mahidol University. Faculty of Pharmacy. Department of Pharmaceutical Botany; Mahidol University. Faculty of Pharmacy. Department of PharmacognosyA survey on medicinal plants at Kungkrabaen Royal Development Study Center, Chanthaburi Province, Thailand, was carried out by interviewing, collecting and identifying the plant specimens, and also comparing the plant specimens with the authentic specimens at three herbaria, the Bangkok Herbarium (BK), the Forest Herbarium (BKF) and the Pharmaceutical Botany Mahidol Herbarium (PBM). Eighty medicinal plants belonging to forty-seven families which were commonly used were reported. They were found belonging to sixty-nine dicots (38 families), ten monocots (8 families) and one fern (1 family), were founded. Thirty-one species were used in combination with other medicinal plants whereas the other fifty-two species were used as a single remedy.