The development of a medication safety management model for patients with chronic non-communicable diseases under the primary care pharmacy service system at King Narai Hospital, Lopburi Province

Abstract

     This research and development project aims to study the medication use situation in patients with chronic non-communicable diseases under the primary care pharmacy system and to develop a model for managing medication safety in patients with chronic non-communicable diseases under the primary care pharmacy system at Phra Narai Maharaj Hospital, Lopburi Province. The study was conducted from December 2025 to August 2026 and comprised three phases: situation analysis and model development, model implementation and refinement, and continued evaluation with expanded implementation. The evaluation group consisted of 382 patients with NCDs who were followed at three time points, together with 13 multidisciplinary team members. Research instruments included a general and correct medication use record form, a drug-related problem and adverse drug event record form, a medication error record form, a medication adherence questionnaire, satisfaction questionnaires, and qualitative interview guides. Data were analyzed using descriptive statistics, the Friedman test, Cochran’s Q test, McNemar test, and content analysis.

     The developed model comprised six components: medication risk assessment, medication review, medication counseling, medication-use follow-up, adverse drug event surveillance, and multidisciplinary team coordination. After implementation, the proportion of patients with correct medication use increased from 66.75% to 92.41%, while the mean medication adherence score increased from 23.40 to 26.58; both changes were statistically significant (p < 0.001). Drug-related problems and adverse drug events decreased significantly. Medication errors decreased from 8.90% to 5.50%, although the difference was not statistically significant (p = 0.086). During the expansion phase, 900 patients met the eligibility criteria and 720 received the model, representing 80.00% coverage. Among 222 patients with complete paired pre- and post-implementation data, both correct medication use and medication adherence improved significantly. The findings indicate that the developed model can be applied to support medication safety management and continuity of primary care pharmaceutical services. Further implementation should emphasize systematic follow-up and completeness of outcome data.