Desires and Attitudes towards Telepharmacy Medicine Delivery.

The COVID-19 pandemic has limited healthcare services for patients with non-communicable diseases (NCDs). Hospital pharmacy departments in Thailand apply a new normal pharmacy service known as "telepharmacy" to serve remote pharmacy practice and deliver medication to patients. Current knowledge clearly shows the benefit of each medicine delivery method, but the study of patient's desires and attitudes towards all drug delivery methods is still limited. To fill the gap, this study aims to investigate desires and attitudes about drug delivery methods among Thai patients living with NCDs who need regular and continuous care. The sample was included by accidentally randomized technique at NCD clinics of the southern Thailand tertiary care hospital. Data were collected between January and March 2021 by a questionnaire that contained three sections: the currently received medicine delivery method, the desires and attitudes about the medicine delivery system, and patients' demographic information. The majority of patients were women aged 60 years who earned less than 10,000 THB (263.85 USD), were enrolled in the Civil Servant Medical Benefit Scheme (CSMBS), lived 0-15 km from the hospital, living with hypertension, had 1-4 prescribed medications, visited the doctor every 3 months, and received the conventional drug delivery method. The result showed that only the subdistrict health promotion hospital (SHPH) medicine delivery method was at a high level of desire, while the rest including conventional, drug store, postal pharmacy, and drive-thru medicine delivery methods were at medium. Attitudes toward the quality of medicine delivery methods consisted of five dimensions: confidence, timeliness, reliability, empathy, and facilities. Thai NCD patients had positive attitudes toward SHPH and drug store medicine delivery methods that could be seen from the high level of attitude score across all dimensions, while postal pharmacy and drive-thru delivery methods received medium-level attitude scores across all five dimensions.

Potential Drug Interaction Between Favipiravir and Warfarin in Patients With COVID-19: A Real-World Observational Study.

Favipiravir is one of the most used antiviral agents for the treatment of coronavirus disease 2019 infection in many countries, including Thailand. This study aimed to investigate the effect of favipiravir-warfarin interaction in terms of changes in international normalized ratio (INR) of patients. Medication charts of all inpatients in a hospital in Thailand between April 2021 and March 2022 were reviewed. Patients who received either warfarin with standard care or warfarin with favipiravir were included. The INR levels of patients were monitored at baseline and the earliest date following treatment, as well as other laboratory parameters. There were 43 and 53 patients in the warfarin-favipiravir and the warfarin-only groups, respectively. Baseline characteristics, such as sex, age, body mass index, and warfarin dose, were not significantly different between the 2 groups. The results showed that the mean INR of patients using favipiravir and warfarin was increased from 2.14 to 3.88 (P < .001), while the patients using warfarin alone had no increase in the mean INR (1.93 vs 1.91; P = .906). Other parameters were not significantly changed, including white blood cell count, red blood cell count, hemoglobin, hematocrit, and liver function. However, an increase in platelet count was observed in the favipiravir-warfarin group, but not in the control group. This real-world study highlighted a significant increase in the INR levels of patients who used favipiravir together with warfarin, compared to patients who used only warfarin. However, the interaction did not affect other laboratory parameters, except an increase in platelet count.