Systems Challenges in Accessing Medicines among Children under Thailand's Universal Health Coverage: A Qualitative Study of a Provincial Public Hospital Network.

Autor:	Daojorn R; Health and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, Thailand.; Omkoi Hospital, Chiang Mai 50310, Thailand., Suwannaprom P; Health and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, Thailand., Suttajit S; Health and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, Thailand., Kanjanarat P; Health and Medicine Policy Center (HMPC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50000, Thailand., Tiengket P; Public Health Promotion, Research and Training Foundation, Chiang Mai 50000, Thailand., Lallemant M; Public Health Promotion, Research and Training Foundation, Chiang Mai 50000, Thailand.; Programme for HIV Prevention and Treatment (PHPT)/IRD Unite, Chiang Mai 50000, Thailand.
Jazyk:	angličtina
Zdroj:	Children (Basel, Switzerland) [Children (Basel)] 2022 Apr 13; Vol. 9 (4). Date of Electronic Publication: 2022 Apr 13.
DOI:	10.3390/children9040552
Abstrakt:	Lack of access to child-appropriate medicines results in off-label use. This study aimed to explore medicine management for paediatric patients and to highlight the challenges of the healthcare system under the universal health coverage of Thailand. Semi-structured interviews were conducted with 35 healthcare practitioners working in the public hospital network of Chiang Mai province from February to September 2020. Participants were asked about their experiences in managing the medicine supply for children. Findings revealed that paediatric patients had limited access to age-appropriate medicines. Children's medicines are rarely selected for inclusion into hospital formularies because of constraining regulations and limited budgets. Additionally, child-appropriate formulations are unavailable on the market. Pharmaceutical compounding is unavoidable. Prepared products are provided weekly or monthly because of product stability concerns. Often, tablets are dispensed, and caregivers are instructed to cut up a tablet and disperse it in syrup in order to obtain a smaller dose in a dosage form appropriate for children to use at home. Without systematic support, access to safe and quality medicines for children is limited.
Databáze:	MEDLINE
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