Herbal Medicines Prescription among Health Care Providers in Primary Health Settings in Rural Thailand: Perceptions and Experiences
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Abstract
Introduction: Although the Thai Ministry of Public Health has set a benchmark prescribing rate of 15% for herbal medicines, recent trends indicate a decline in this rate. This study explored perceptions of and experiences with herbal medicine prescriptions among health providers working in primary health settings. Methods: A descriptive qualitative approach was employed, utilising three focus group discussions with 12 primary care unit administrators, 10 public health providers from primary healthcare units and five Thai traditional medicine practitioners. The data were analysed using thematic analysis method. Results: Four key themes emerged: 1) Perceptions and experiences of herbal medicine policies, 2) The current situation of prescribing herbal medicines in primary healthcare units, 3) Barriers to enhancing the prescription of herbal medicines, and 4) Strategies for increasing the prescription of herbal medicines in primary healthcare units. The findings revealed that healthcare facilities with Thai traditional medicine practitioners had a higher frequency of herbal medicine prescription. Despite supportive health policies promoting herbal medicine integration, many facilities without Thai traditional medicine practitioners did not prioritise the prescription of such medicines. Concerns about the potential adverse effects of combining modern and herbal treatments contributed to hesitancy among healthcare providers in prescribing herbal remedies. Conclusion: This research highlights the importance of enhancing traditional medicine use in primary healthcare, particularly in rural areas. Increasing awareness of herbal medicine policies and providing support to healthcare professionals are essential steps towards boosting the prescription of traditional medicines and ultimately promoting local wisdom and practices in rural communities in Thailand.
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Rawangpan P, Jampangern S, Opaswattana O, Aemsomboon O. The situation of Thai traditional medicine services at public health facilities in Suphan Buri province. J Thai Tradit Altern Med. 2018;16(2):268-283. Available from: https://he01.tci-thaijo.org/index.php/JTTAM/article/view/140509.
Pratumchat T, Kessomboon P. Prescribing herbal medicine for patients by health care officers at Tambon Health Promoting Hospitals in Nongbualamphu province. Community Health Dev Q Khon Kaen Univ. 2015;3(1):97-112. Available from: https://gsbooks.gs.kku.ac.th/58/the34th/pdf/MMP46.pdf.
Meksawasdichai C. Evaluation of policies promoting the use of herbal medicine in hospitals in the ministry of public health in Saraburi province in 2017. J Thai Tradit Altern Med. 2019;17(3):5162-5166. Available from: https://he01.tci- thaijo.org/index.php/JTTAM/article/view/232344.
Thong-ngamdee S. Distribution of herbal medicine and results promoting the use of herbal medicines in public health facilities, Phichit province, from the herbal medicine subsidy policy of health region 3. Phichit Public Health Res Acad J. 2022;3(2):30-37. Available from: http://www.ppho.go.th/webppho/research/y3p2/b04.pdf.
Khaesuntia P, Kanjanarach T. Problems and suggestions for substituting modern medications with herbal medicines in public hospitals: A pilot study from the perspective of health professionals at community hospitals in the Northeast. Thai J Pharm Pract. 2021; 13(4):837-846. Available from: https://he01.tci- thaijo.org/index.php/TJPP/article/view/243043/166578.
Kitchalow P, Wayurakul W. Factors related to prescribing herbal medicines listed in national list of essential medicines among hospital-based physicians in Pathum Thani province. Res Dev Health Syst J. 2022; 15(2):145-158. Available from:https://he02.tci-thaijo.org/index.php/RDHSJ/issue/view/17757.
Noipha K, Kamlungmak S, Chaimay B, Suwannarat R. Perception of using herbal medicines in nation list of essential medicines among outpatients at internal medicine department and medical doctors in Phattalung hospital. J Thai Tradit Altern Med. 2017;15(3):333-351. Available from:https://he01.tci- thaijo.org/index.php/JTTAM/article/view/107634.
Chutitrakuchai A, Hongsanun W. Factors influencing turmeric (curcuma longa linn.) use behavior among people in Sukhothai province. J Public Health Naresuan Univ.2021;2(2):26-36. Available from: https://he01.tci-thaijo.org/index.php/JPHNU/article/view/243907.
Harinawan P, Damnoenssawat W, Srikajang P, Maneewong N. Usage of herbal alternatives to modern medicine in Lampang hospital and community hospitals in Lampang province. J Health Syst Res. 2009;3(3):412-418. Available from: https://kb.hsri.or.th/dspace/handle/11228/2871?show=full.
Public Health Office Pattani Province. Dosage of herbal medicines compared to total number of prescriptions 2022. Pattani province, Thailand: Public Health Office Pattani Province; 2022.11. Public Health Office Pattani Province. Policy for substituting modern medications with herbal medicines 2020. Pattani province, Thailand: Public Health Office Pattani Province; 2019.
Tsele-Tebakang T, Morris-Eyton H, Pretorius E. Herb-drug interactions: Perception and
revelations of nurses in primary healthcare clinics, South Africa. Int J Afr Nurs Sci 2022;16(1):100409. doi:10.1016/j.ijans.2022.100409.
Zimmerman C, Kandiah J. A pilot study to asse ss students’ perceptions, familiarity, and knowledge in the use of complementary and alternative herbal supplements in health promotion. ATHM. 2012;18(5):28-33. Available from: https://pubmed.ncbi.nlm.nih.gov/22894888/.
Hussain FN, Rainkie D, Alali FQ, Wilby KJ. Association of pharmacy students’ cultural beliefs with perceived knowledge, beliefs, confidence, and experience with complementary medicine. Curr. Pharm. Teach. Learn. 2021;13(2):159-163. doi: 10.1016/j.cptl.2020.09.009.
Susanto T, Rasni H, Susumaningrum LA . Using values of local wisdom for family healthcare of adolescents in the Indonesian context. Sri Lanka J. Child Health. 2019;48(3):256-258. doi: 10.4038/sljch.v48i3.8762.
Sirasoonthon P. Concept, theory and technique for social development practice. Bangkok: CU Press; 2013.
Toharudin U, Kurniawan IS. Value of local wisdom: A potential to develop an assessment and remedial. IJERE. 2017;6(1):71-78.doi:10.11591/ijere.v6i1.6349.
Aurchitme N, Fakkham S. The study of folk healer wisdom in Chindamanee. IJHSS. 2022;8(3):298-305. Available from:https://so05.tci-thaijo.org/index.php/pacific/article/view/265075.
Nunart N. Local wisdom as the value of life and culture for sustainable education. Soc. Sci. Res. 2017;12(34):17-26. Available from:https://so05.tci-thaijo.org/index.php/JSSRA/article/view/59467.
Lambert VA, Lambert CE. Qualitative descriptive research: An acceptable design. PRIJNR. 2012;16:255-256. Available from:https://he02.tci- thaijo.org/index.php/PRIJNR/article/view/5805.
Roudsari RL. Qualitative description: A less sophisticated approach for junior qualitative researchers. JMRH. 2019; 7(4):1856-57. doi: 10.22038/JMRH.2019.13927.
Liamputtong P. Focus group methodology: principle and practice. London: Sage; 2011.
Suwankhong D, Chinnasee, C, Rittisorakra, C, Meksawi S, Rosenberg, M. Perceptions of physical activity among older adults in rural communities southern Thailand. MJMHS. 2020;16(1):155-161. Available from:https://www.researchgate.net/publication/349126256_.
Liamputtong, P. Qualitative research methods (5th ed.).Oxford University Press; 2020.
Nyumba TO, Wilson K, Derrick CJ, Mukherjee N. The use of focus group discussion methodology: Insights from two decades of application in conservation. MEE. 2018;9(1):20-32.doi:10.1111/2041-210X.12860.
Wong LP. Focus group discussion: A tool for health and medical research. SMJ.2008;49(3):256-260. Available from: https://pubmed.ncbi.nlm.nih.gov/18363011/.
Sanalad R, Kittiboonyakhun P, Nualkaew S. Effects of the intervention for promoting the prescribing of herbal medicines in the national lists of essential medicines in community hospitals at Mahasarakham province. TJPS. 2021;13(4):933-943. Available from:https://he01.tci-thaijo.org/index.php/TJPP/article/download/245181/166870/.
Virasombat N, Prakobkij W, Tunthaworn T, Riyachan P, Sudto M, Ouaysawat M, et al. Herbal medicine usage in current health service system: A case study of Sung Noen contracting unit of primary care-CUP, Nakhon Ratchasima province. J Thai Tradit Altern Med. 2011;9(1):47-56. Available from:https://he01.tci- thaijo.org/index.php/JTTAM/article/view/122114.
Roekruangrit N. Factors influencing on use of herbal medicinal products in U-Thong Hospital, Suphanburi Province (Master thesis). Bangkok, Thammasat University; 2010.
Sanalad R. Development of guidance for supporting the use of national lists of Thai herbalmedicines in community hospitals, Mahasarakham province (Master thesis). Mahasarakham, Mahasarakham University; 2020.
Pacharavanich N, Boontha N, Wangmaneerat A. The study of opinions and experience of physician on prescribing herbal medicine in Ubon Ratchathani Province (Project report). Ubon-Rajathanee, Ubon-Rajathanee University; 2004.
ALkharashi NA. The consumption of nutritional supplements and herbal products for the prevention and treatment of COVID-19 infection among the Saudi population in Riyadh. Clin Nutr Res. 2021;39:11-20. doi:10.1016/j.nutos.2021.09.001.
Panthes K, Prutipinyo C, Aimyong N. Factor related with utilizing of Thai traditionalmedicines knowledge in primary health care service, Chachoengsao province. PH.PL. 2021;7(3):397-409. Available from:https://so05.tci-thaijo.org/index.php/journal_law/article/view/250853.
Lin YJ, Chang HT, Lin MH, Chen RY, Chen PJ, Lin WY, et al. Professionals’ experiences and attitudes toward use of Traditional Chinese Medicine in hospice palliative inpatient care units: A multicenter survey in Taiwan. Integr Med Res. 2021;10(2):100642. doi.doi:10.1016/j.imr.2020.100642.