Inappropriate self-medication and limited health literacy are pressing challenges that contribute to poor health outcomes among older adults. In rural, low-resource settings, these issues are worsened by digital exclusion, which restricts access to reliable health information and informed decision-making. To assess the prevalence and determinants of inappropriate medication and health product (M&HP) use among older adults in rural Thailand, reflecting wider disparities in Southeast Asia. A cross-sectional survey was conducted among 1,461 older adults aged ≥60 years, selected through stratified multi-stage sampling from Thailand's Health Regions 7-10, which encompass 20 northeastern provinces. Structured interviews explored health-seeking behavior, digital literacy, and M&HP use. Inappropriate use was defined as the use of two or more items without professional consultation, as per national guidelines. Descriptive and multivariable logistic regression analyses were performed. Of participants, 84.5% reported using M&HPs without professional consultation, and only 14.0% were proficient in accessing health information via smartphones. Inappropriate use was significantly associated with rural residence (aOR = 6.33; 95% CI: 2.19-18.31), low education, chronic illness, unemployment, digital illiteracy, and financial hardship (p < 0.05). Digital and social exclusion strongly influence unsafe self-medication practices among older adults. Improving digital health literacy and access to credible information is crucial for enhancing medication safety. Thailand's experience may offer valuable guidance for developing inclusive aging strategies in other low- and middle-income countries.

Introduction: This participatory action research was conducted by the collaborative health-related team in a district, in Thailand. The community network jointly developed a care model for diabetic patients in primary care using the Chronic Care Model (CCM) and evaluated the effectiveness of implemented model. Methods: Data was collected between October 2021 and March 2022 and involved 2 groups: 1) a community network of 25 people including representatives of the community hospital, primary care hospital, Sub-district administrative organization, community leaders, community representatives, representatives of diabetic patients, and representatives of caregivers of diabetic patients, and 2) 41 people with type 2 diabetes and 41 of their family caregivers. The research was conducted in 4 stages: planning, action, observation, and reflection. Results: Both quantitative and qualitative data were collected, and the overall average knowledge scores of diabetic patients, family caregivers, and community representatives significantly increased from before (6.07 ± 2.11, 7.07 ± 1.98, P = .024, 5.74 ± 1.88, 7.37 ± 2.25, P < .001, 7.47 ± 2.44, 8.99 ± 1.72, P = .010) respectively. For satisfaction, diabetic patients were most satisfied with family caregiver support, while the community network representatives were most satisfied with their participation in planning a model for diabetic patients in primary care. After model implementation, the blood sugar-controlled patients (HbA1c < 7 mg%) significantly increased (0 and 9.76%, P = .045), although the fasting blood sugar (FBS) of diabetic patients did not improve. Conclusion: The development and implementation of diabetes care based on CCM, promoted community participation and involvement in diabetes care. This model mainly affected diabetic patients who could control their HbA1c level and the satisfaction of the community network.

Background Older age increases the likelihood of chronic diseases and polypharmacy with the likelihood of potentially inappropriate medications (PIMs) in secondary and tertiary care levels, but in the primary care settings of Thailand there still is a need for more evidence. This study aimed to examine the prevalence of PIM in primary care settings, and to identify factors that influence the use of PIM. Methods A cross-sectional retrospective study was conducted in 2017. Eight primary care units from four regions of Thailand were randomly selected. People aged ≥ 60 years in the eight units were studied as participants. The List of Risk Drugs for Thai Elderly (LRDTE) was used as the reference. Multivariate logistic regression was carried out to identify factors that influence. Results A total of 4,848 patients aged ≥60 years with 20,671 prescriptions were studied. The mean age was 70.7±8.3 years for males, and 61.2% for females. A little more than 5% (5.1%) had ≥ 3 chronic diseases and 15.0% received polypharmacy ( ≥5 medications). The prevalence of prescriptions with PIMs was 65.9%. The most frequent PIMs were antidepressants: amitriptyline (28.1%), antihistamines: dimenhydrinate (22.4%) and chlorpheniramine maleate (CPM) (11.2%); and Benzodiazepines: lorazepam (6.5%). Three factors that significantly influenced prescribing of PIMs were polypharmacy (adjusted OR 3.51; 95% CI 2.81-4.32), having ≥3 chronic diseases (adjusted OR 1.44; 95% CI 1.04-2.01), and age ≥75 years (adjusted OR 1.18; 95% CI 1.01-1.38). Conclusion More than two-thirds of elderly Thai patients in the primary care settings were prescribed PIMs. Multidisciplinary prescription review and PIM screening in patients aged ≥75 years who have ≥3 chronic diseases or polypharmacy should be implemented in primary care and supportive computerized PIMs alert system is needed.

Introduction: A health literacy promotion program in drugs and health products was collaboratively developed and evaluated for effectiveness by researchers and stakeholders. Methods: A Solomon four-group randomized study was conducted in 2022. The participants were people aged ≥60 years enrolled at senior schools in Northeast Thailand. One hundred and eighty older people were randomly selected using multistage sampling and allocated into four groups, 45 members. The designed program covers six skills: access to health information, cognition, communication, decision-making, media literacy, and self-management. ANOVA and t-test were used. Results: One hundred percent response rate, participants of the program (Group 1) showed a significant improvement (pre–post) of 62.2% in their health literacy in drugs and health products use (151.54 ± 37.88, 245.73 ± 9.33, P < 0.001). Group 3, older people who joined the program with posttest only showed health literacy of 248.67 ± 11.54. In contrast, Group 2 and Group 4 with no program showed less health literacy of 149.02 ± 32.08 and 145.22 ± 34.14, respectively. On each item, the older people with the program consistently scored significantly higher across all domains (P < 0.001). The average score was 247.20 ± 10.54, which showed a high level of health literacy (≥75%). Among areas, decision-making skills revealed the highest score of 45.97 ± 1.81 out of 50. The overall satisfaction score on the program was 47.60 ± 1.50. Conclusion: The program demonstrated its effectiveness in improving the older population’s health literacy regarding drug and health product use. It holds potential as a strategy to encourage older people to rational drug use. Participants expressed a significant satisfaction with the program, recommended for the broader Thai older people community.