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Views of Health Professionals on Herbal Medicine and

Policy for Promotion of Herbal Medicine Use in Healthcare Settings

2554

(.)



6 6

. . . 11000 : 0-2590-4549, 0-2590-4374-5 : 0-2590-4369Website : www.hitap.netE-mail : [email protected]

1 2554 500

:

119/138 11 . 3 .. . . 11000 : 0-2525-1121, 0-2525-4669-70 : 0-2525-1272E-mail : [email protected]



iii

I

. . .

.. . . . .



ivHealth Intervention and Technology Assessment Program

/ 1)

2)

3) /.. 2552 - .. 2552

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1) 2) 3) 4)

2.

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3. (key person)



v

4.

1.

2.

academic detailing

3. Good Manufacturing Practice (GMP)

/1.

2.

3. 4.

5.

//



Executive Summary

A number of policies on the promotion of herbal medicinal products have been

implemented for several years; however, the increase in expenditure and utilization rate of

herbal medicinal products has not yet achieved the target set by the Ministry of Public Health.

To achieve the goal, knowing health care professionals views on herbal medicinal products and

on the national policy which aims to promote the utilization of herbal medicine in health care

facilities is crucial. The objectives of this study are to explore the opinions of health care

professionals on the following issues: 1) herbal medicinal products; 2) the national policy to

promote the utilization of herbal medicinal products in health care facilities; and 3) the

facilitating and impeding factors influencing the utilization of herbal medicinal products in health

care facilities. In this study, group interview was conducted among health care professionals,

who worked in health care facilities, which reported the high utilization rate of herbal medicinal

products. On the other hand, in-depth interviews were conducted among health care

professionals, who worked in the health care facilities, which reported a low utilization rate of

herbal medicine products. Data collection was conducted between April to May 2009.

The results of this study can be divided into 4 parts:

1. Views on herbal medicinal products: 1) Physicians still lack confidence in the

effectiveness and safety of herbal medicinal products; 2) The appearance and other

characteristics of herbal medicinal products are not attractive; 3) Herbal medicinal products are

more expensive than western medicine; 4) Physicians lack confidence in the quality and

manufacturing standards of herbal medicinal products.

2. Views on the national policy to promote the utilization of herbal medicinal

products in health care facilities: The set target in terms of expenditure of herbal medicinal

products of 25% of the total drug expenditure for every health care facilities, is difficult to

accomplish, especially in tertiary care hospitals. Furthermore, there are no practice guidelines

and clear strategic plan to support the policy.

3. Views on facilitating factors influencing the utilization of herbal medicinal

products in health care facilities: Key facilitating factors are: existence of a key person in

hospitals; substitution of herbal medicinal products for conventional drugs; provision of

information on herbal medicinal products to new physicians in the hospital; and provision of free

herbal medicinal product samples for physicians use.

ivHealth Intervention and Technology Assessment Program



4. Views on the impeding factors influencing the utilization of herbal medicinal

products in health care facilities: Key impeding factors are: number of drug list in the

hospital; and criteria on reimbursement of herbal medicinal products.

Recommendations for health care facilities

1. Organization of training on herbal medicinal products for physicians and key persons

in the hospital.

2. Employment of strategies for the promotion of herbal medicinal products in the

hospital, such as substitution of western medicine for herbal medicinal products, provision of

education in various strategies including academic detailing, and promotion of the use of herbal

medicine via traditional health professionals.

3. Compliance with Good Manufacturing Practice (GMP) standards for production.

Control of the quality of raw materials and finished products.

Recommendations for policy makers

1. Promotion research and development (R&D) of herbal medicinal products in terms of

analysis of active ingredients, manufacturing technology, and clinical research for herbal

medicinal products.

2. Assignment of a central authority for the systematic and comprehensive management

of a national database on herbal medicinal products and promotion of easy access of to the

database.

3. Inclusion of knowledge on herbal medicinal products in the medical curriculum.

4. Increase of the number of herbal medicinal products in the National List of Essential

Drugs and coordination with health insurance schemes to improve the reimbursement system

for herbal medicinal products.

5. Target setting for the use of herbal medicinal products mainly on primary and

secondary health care settings.

It should be noted that many recommendations from this study are similar to those

specified in the strategic plan of several previous national policies. Therefore, to achieve the

goal, reinforcement and monitoring and evaluation of the policy should be implemented more

strictly.

v



.................................................................................................................. I..................................................................................................................... IIEXECUTIVE SUMMARY....................................................................................................IV.................................................................................................................................VI ..........................................................................................................................VIII .......................................................................................................................IX 1. ........................................................................................................... 12....................................................................................................... 3

2.1

.....................................................................3

2.1.1 ............................................................32.1.2 /....................................42.1.3 ................................................................................ 112.1.4 .. 2542.112.1.5 .. 2550 ..2552 .................................................................................................112.1.6 (.. 2548 - 2552)............................................................................................................................... 122.1.7 .. 2550 - 2554............................................................................................................................... 13

2.2. .................... 162.2.1 ......................................................162.2.2 .............................................................................. 162.2.3 ....................................... 17

2.3 .........................................................192.3.1 (GMP) ......192.3.2 ...............................................................202.3.3 ...............................222.3.4 ...............................232.3.5 ................................25

2.4 ........................282.4.1 ................................................................. 28

2.5 ................................................................................................ 333. ....................................................................................................... 36

viHealth Intervention and Technology Assessment Program


http:///reader/full/raayngaanwicchaykhwaamkhidehnkhngbukhlaakrsaathaarnsukhtyaacchaaksmunaiphraelanoy 10/90

4. ................................................................................................................ 364.1 (Study design) ............................................................................364.2 (Data collection)............................................................................... 36

4.2.1 ......................................................................................... 364.2.2 ...................................................................................... 37

4.3 (Data analysis) .........................................................................395. ................................................................................................................... 396. .............................................................................517. ................................................................................................................. 638. ....................................................................................................................... 69

vii



1 GDP

.. 2538 2548..................1 2 .. 2530 - 2550....................................................................................2

3 ........................................................................................................ 15

4 (GMP).. 2543 - 2553.................................................................................................20

5

.......................................................21

6 .. 2526 - 2552.........................22 7 .. 2530 - 2550.23 8 2,521

................................................................................................................................... 31

viiiHealth Intervention and Technology Assessment Program



1

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3 25 () 318 ............................................................................................................... 27

4

.. 2548 - .. 2552 ...........................................................................30 5 ...............................37 6

............................................................................ 58

ix



xHealth Intervention and Technology Assessment Program



1

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Health Intervention and Technology Assessment Program

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[68]

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54


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[32] [70, 71] 2

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