Abstract
The refilling of prescriptions for patients with chronic diseases under Thailand’s Universal
Coverage Scheme (UCS) by a private community pharmacy was developed as the model for a
health-care network linking the pharmacy and primary care units under the UCS. The objective of
this study was to compare the outcomes of the pharmacy providing health-care services for stablechronic patients, including those with diabetes mellitus, hypertension and dyslipidemia, between
those of the community pharmacy and primary care units. The quasi experimental study and
qualitative study were conducted during the period from December 1, 2005 to November 30, 2006.
Data collection was performed using pluralist methodology, including patient clinical data, questionnaire,
observation and telephone interview. The percentile, mean, standard deviation were
calculated. Levene’s test for equality of variances, paired t-test, and independent t-test were used
for comparing the clinical data. The patients were divided into a treatment group (n=27) and a
control group (n=69). The treatment group repeatedly refilled their prescriptions at the pharmacy
whereas the control group obtained normal services at the Phra Samuth Jadee Hospital, the main
contractor. After six months, clinical outcomes were compared between both groups. The results
revealed that the fasting blood sugar level, systolic blood pressure and diastolic blood pressure
between the treatment and the control group were not significantly different (p-values = 0.875,
0.770 and 0.706, respectively). The results of a telephone interview with the treatment group indicated
that the overall satisfaction with the services was 63.5 percent. Interestingly, the satisfaction
in the fast and convenient services among the patients who refilled their medications at the pharmacy
was 100 percent. These results indicated that the refill prescription service by the pharmacy
is as effective as that by the hospital. This study confirms the distinct and important roles played by
community pharmacists in delivering pharmaceutical care to chronic patients. In addition, the
pharmacy could be a health-care provider serving as a subcontractor in the health-care network
under the Universal Coverage Scheme in Thailand. This could improve and develop the quality of
the overall health-care services. This health-care service model provides more access to care and
increases the treatment quality of patients.
