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Objective. To implement and evaluate 5 integrated teaching modules in the fifth-year doctor of pharmacy (PharmD) curriculum to increase students' ability to promote patients' health as part of their pharmacy practice. Design. Activity-based learning was added to each module: (1) a practice experience in which students provided health information and counseling to the public; (2) academic debates on current issues in pharmacy (3) journal clubs on articles from the pharmacy literature; and (4) research projects relating to ongoing faculty research on diabetes. Students on 12-week practice experiences had visits to patients in inpatient wards, outpatient clinics, and either primary care units or community pharmacies. Assessment. Practice examinations at the end of the first semester, the average student score was above 80% as determined by preceptors in experience sites and from faculty members. Group interviews found that students were positive about the benefits of integrated teaching. Conclusion. The integration of the teaching between modules in the same semester is possible and greatly benefits student learning.Keywords: active learning, pharmacy practice, pharmacy practice experience, PharmD curriculum, health promotion, Thailand INTRODUCTIONOnly 6 of the 15 universities with pharmacy programs in Thailand offer the 6-year PharmD curriculum.1-6 The standard requirements for the PharmD curriculum has/ have been published by the Ministry of Education. 7 The Faculty of Pharmacy, Mahasarakham University, was the second university in Thailand to establish the 6-year PharmD program. We accepted our first students into the program in 2000. The current PharmD curriculum requires 240 credits including 30 credits in general education, 30 credits in basic sciences, 87 credits in professional health sciences, 65 credits in clinical pharmacy, 18 credits in research, and 10 credits in elective subjects. The curriculum includes lecturing and active learning in the first through fifth years, and practice skills in hospitals and community pharmacies in the second through sixth years (year 2 5 48 hours, year 3 5 80 hours, year 4 5 400 hours, summer of year 5 5 150 hours, and year 6 5 5 practice experiences of 225 hours each. 1Teaching of pharmacy modules in Thailand is generally delivered independently for each specialty. Students have been taught many different modules without any strategy to help them conceptually apply their knowledge to promote people's health in their pharmacy practice. Since health promotion is an important issue throughout Thailand, the Pharmacy Network for Health Promotion (PNHP) in 2004, led by Associate Professor Dr. Jiraporn Limpananont, introduced the idea of health promotion being included in the Thai pharmacy curriculum of all 15 universities offering a pharmacy degree. 8 The aim of the PNHP was for pharmacy students to become pharmacists who were up-to-date in global health matters and who could play a role in the rational use of medicines and health promotion.8 Competence in health promotion is ...

ProblemThailand passed the Persons with Disabilities Empowerment Act in 2007. The Act, which is in compliance with the United Nations Convention on the Rights of Persons with Disabilities, ensures that registered persons with disabilities are entitled to home environment modifications’ benefits up to a maximum of 20 000 baht (670 United States dollars); however, the Act’s enforcement is still weak in Thailand.ApproachIn 2013, researchers developed a home modification programme, consisting of a multidisciplinary team of medical and nonmedical practitioners and volunteers, to modify homes for persons with disabilities. The programme recruited participants with physical disabilities and assessed their functioning difficulties. Participants’ homes were modified to address identified functioning difficulties.Local settingThe project was implemented in four provinces in collaboration with staff from 27 district hospitals located in north-eastern Thailand.Relevant changesAfter the home modifications, all 43 recruited participants reported reduced difficulties in all areas, except for participants with severe degrees of difficulties, such as those reporting being unable to walk and unable to get up from the floor. The participants’ quality of life had also improved. The average EQ-5D-5L score, measuring quality of life, increased by 0.203 – from 0.346 at baseline to 0.549 after the modifications.Lessons learntHome modifications in low-resourced settings are technically and financially feasible and can lead to reducing functioning difficulties and improving the quality of life of persons with disabilities. Implementation requires government subsidies to finance home modifications and the availability of technical guidelines and training on home modifications for implementing agents.

Rationale, aims, and objectives: The prescription of potentially inappropriate medication (PIM) is a global issue associated with increased adverse drug events, mortality, and health care expenditure. Computerized decision support system (CDSS) for the detection of PIM is a novel alert system in Thailand for reducing PIM prescriptions. The aim of this study was to evaluate the effect of a CDSS on PIM prescriptions for elderly patients in Thai community hospitals. Methods: The study design comprised two phases with a duration of 12 months each: pre-CDSS implementation (October 2015-March 2016) and post-CDSS implementation (October 2016-March 2017). Medical services and prescription claims data from four hospitals were used to calculate the prevalence of PIM prescriptions among elderly patients aged 60 years and older. Chi-square tests were used to analyse changes in PIM prescriptions across hospitals post CDSS.Results: The overall prevalence of PIM prescriptions post-CDSS implementation significantly decreased from 87.7% to 74.4%. The severity of mild and moderate PIMs was significantly reduced from 71.9% to 49.0% and from 64.5% to 48.7%, respectively. All hospitals had only one severe PIM, which was hyoscine. It was reduced from 4.7% to 1.5%, but the change was not significant (P = 0.74). The proportion of frequently prescribed PIMs in all PIM levels was significantly decreased, regardless of existing alternative medications.Conclusions: Specific CDSS for PIM in community hospital setting was associated with a reduction of PIM prescription in elderly patients. This CDSS can change physician's prescription behaviour to avoid inappropriate medications. KEYWORDS computerized decision support system, elderly patients, potentially inappropriate medication prescription

A primary care service of one educational institution was a study site. Eight common illnesses were emphasised. Patient visits were observed, prospectively at community pharmacy and retrospectively at PCU, during August to October 2013. Labour and material costs related to management of common illnesses were recorded. Total cost divided by total patient visits determined the unit cost. For the community pharmacy, patients were followed up after 3-14 days of visit to evaluate the effectiveness. Sensitivity analysis was performed by varying direct medical cost at ±10-30%. Findings At the community pharmacy, community pharmacists performed multiple tasks including interviewing and assessing patients, choosing an appropriate treatment and dispensing. Of 9141 visits, 775 (8.5%) with common illnesses were included. Upper respiratory disorder was found the highest 41.9% (325/755). Unit cost of treatment ranged from 54.16 baht (£1.18) for pain to 82.71 baht (£1.80) for skin disorder. Two-thirds of pharmacy visits (77.9%, 539/692) reported complete recovery. Managing common illnesses at the PCU was performed by nurse assistants, nurses, doctors and pharmacists. Of 6701 patient visits to the PCU, 1545 (23.1%) visits were at least one of the eight illnesses. Upper respiratory disorder was the majority, 53.0% (771/1454). Unit cost of treatment ranged from 85.39 baht (£1.86) for eye/ear to 245.93 baht (£5.36) for sexual health. Managing common illness at a community pharmacy shows satisfactory effectiveness with lower unit cost.