Abstract
Introduction Pharmacies are a crucial part of primary healthcare systems, providing convenient
and rapid access to health services, particularly within the Thai community setting where
pharmacies are closely integrated. The COVID-19 pandemic has underscored the importance of
reducing hospital overcrowding and decentralizing healthcare services. The development of a
seamless pharmacy network in the healthcare system is an essential strategy to support the
healthcare framework, utilizing technologies such as electronic prescriptions and establishing
prototype pharmacies to expand the role of pharmacists in primary care. Objectives The project
to develop a seamless pharmacy network in Thailand's healthcare system aims to enhance
healthcare efficiency, alleviate hospital congestion, and improve public access to health services
through a pharmacy network. The project is divided into two sub-projects: 1) Prototype hospital
electronic prescription systems under the state hospital congestion reduction initiative (Model 3)
and 2) Expanding access to healthcare services in Health Region 7 through the development of a
pharmacy network. Methods This study employed a mixed-methods approach, including quasi-experimental quantitative studies to evaluate service outcomes and qualitative studies through
in-depth interviews and focus group discussions to synthesize policy recommendations. Results
The initiative resulted in the establishment of prototype hospitals with electronic prescription
systems under the Model 3 congestion reduction project, including Nakhon Ratchasima
Rajanagarindra Psychiatric Hospital, Department of Mental Health. The project integrated a
network of 45 pharmacies, with 17 pharmacies using Model 3 systems. These pharmacies served
390 patients, processing 5,862 prescriptions. In Health Region 13 (Bangkok), 48 pharmacies
participated, supporting services from four hospitals: Rajpipat Hospital (18 pharmacies), Klang
Hospital (12 pharmacies), Sirindhorn Hospital (10 pharmacies), and Luang Por Taweesak Hospital
(8 pharmacies). The services covered chronic diseases, such as hypertension, diabetes,
hyperlipidemia, and prostatic hyperplasia. Overall pharmacist satisfaction with the project was
high (3.83 ± 0.71 out of 5), although satisfaction with compensation was moderate (2.75 ± 1.235).
For Health Region 7, 96 pharmacies participated in Common illness service, covering 30 of the 77
districts (38.96%). Distribution by province included: Roi Et Province: 26 pharmacies in 11 of 20
districts (55%), emphasizing prototype services such as minor illness management, disease
screening, and E-prescription services, enhancing holistic and comprehensive care. Khon Kaen
Province: 49 pharmacies in 9 of 26 districts (34.62%). Maha Sarakham Province: 16 pharmacies in
5 of 13 districts (38.46%). Kalasin Province: 5 pharmacies in 5 of 18 districts (27.78%).
Recommendations The study recommends increasing public awareness to foster understanding
and acceptance of the project, allocating funds and resources to expand pharmacy services in
uncovered areas, enhancing information systems for effective data integration, and supporting
appropriate compensation for pharmacists to encourage participation. Expanding prototype
pharmacies based on Roi Et's success is also advised. Conclusion Developing a seamless
pharmacy network reduces hospital congestion, enhances the role of pharmacies in the
healthcare system, and improves public access to services. Roi Et Province's success highlights
the potential of this approach, emphasizing the need to support and scale the initiative
nationwide for comprehensive coverage.
