Factors influencing patient intention to report adverse drug reaction to community pharmacists: A structural equation modeling approach.

BACKGROUND: Under-reporting of adverse drug reactions (ADRs) is the main problem of spontaneous ADR reporting systems, especially reporting from community pharmacists. However, community pharmacists cannot report ADRs if patients do not report them. OBJECTIVE: To investigate factors that can influence patients' intention to report ADRs to community pharmacists and to develop a structural model of influencing factors to report ADRs from patients. METHOD: Self-administered questionnaire via a Google form was used. The study samples were people living in all regions of Thailand. Structural equation modeling (SEM) was used to determine the influencing factors to intention to report ADRs to community pharmacists. RESULTS: A total of 2774 responses were collected. All Pearson correlations among variables were statistically significant. The correlation between intention to report ADR and instrumental attitude was highest. Perceived behavior control had the lowest correlation with intention to report ADRs. The structural equation model was an adequate fit for the data. Intention to report ADRs to community pharmacists was significantly influenced by instrumental attitude, injunctive norm, descriptive norm and self-efficacy. CONCLUSION: Positive attitude of ADR reporting, self-efficacy and their reference person such as physicians, community pharmacists, their families and friends could encourage and motivate their intention to report ADRs to community pharmacists.

Health seeking behavior among insured persons under the Social Security Act, 1990.

Since having health insurance cannot guarantee access to care among the insured persons, their actual health seeking behavior should be evidence reflecting true access. Therefore, the study aimed to present the patterns of health seeking behavior among the insured persons who actually were able to get free services from their registered hospitals under the Social Security Scheme. Purposive sampling was done of 1,003 insured persons who were willing to participate in the study from small, medium and large establishments in the Huai Khwang district in Bangkok. A health diary was employed as one of the data collecting tools with a follow-up period of six months. The average illness rate found was 6.44 episodes/person/year. The characteristics of illnesses reported were described in terms of symptom groups, perceived severity, duration, work or non-work related cause. No treatment or self care, seeking help from non-registered health facilities and seeking help from registered hospitals and clinics were the patterns of health seeking behaviors found in the study. The patterns of health seeking behaviors among the participants varied depending on the stage of treatment, perceived severity of illness and types of additional health benefits. Seeking care from registered hospitals and clinics was found among the illnesses with a higher level of perceived severity, among the participants with chronic diseases, and among the illnesses that were treated with higher stages. Therefore, health insurance might not be able to guarantee true access to needed care for people unless the comprehensive health care provider networks are designed to cover more types of services, be more convenient and have more accessible health care providers.