Int
ern
at
i
onal
Journ
al of
P
u
bli
c Hea
lt
h S
c
ie
nce (IJPH
S)
Vo
l.
6
,
No.
4
,
D
ece
m
ber
201
7
, pp.
283
~
287
IS
S
N:
22
52
-
8806
,
DOI: 10
.11
591/
ij
phs
.
v6
i
4
.
9
436
283
Journ
al h
om
e
page
:
https:
//
ww
w.i
aesco
re
.c
om
/j
our
nals/
ind
ex.
php/IJP
H
S
Abili
ties of Vill
ag
e Health
Volunte
ers in
Determinin
g Drug
Relat
ed P
ro
bl
em
s for Dia
betes an
d Hyp
ertension P
atients
Parin
a Na Pa
t
ha
lun
g
1
, P
h
ayong Thep
akso
rn
2
1
Pharm
acy
Te
c
hnique
Dep
art
m
ent
,
Sirindhorn
Coll
ege of
Publi
c
Hea
lt
h
,
T
ran
g
,
Tha
iland
2
Tra
ng
Rese
arch Ce
nt
er
for
Occ
upat
ion
al
He
alth
,
Sirindhorn
Coll
ege
of
Publi
c
He
al
th
,
T
ran
g
,
Th
ailand
Art
ic
le
In
f
o
ABSTR
A
CT
Art
ic
le
history:
Re
cei
ved
Sep
2
4
, 201
7
Re
vised
N
ov
20, 2
01
7
Accepte
d
Dec
6,
201
7
The
obj
ec
t
ive
o
f
thi
s
stud
y
wa
s
to
assess
the
Vill
ag
e
Hea
l
th
Volunte
ers
(VH
Vs
)
on
the
ir
knowledge
and
skill
s
for
det
ermining
drug
-
related
proble
m
s
(DRP
s)
for
h
y
pe
rte
nsion
(HTN)
and
di
abe
t
es
(DM
)
pat
i
ent
s.
T
hi
s
stud
y
wa
s
conduc
t
ed
amo
ng
36
VH
Vs
bet
wee
n
Marc
h
and
Octob
er,
2
014
in
t
en
distri
ct
s
of
Tra
n
g
Province
.
The
sem
i
-
struct
ure
d
questi
onnaire
in
t
erv
ie
ws
and
te
sts
hav
e
be
en
deve
lop
ed
a
cc
or
ding
to
knowl
ed
ge
and
skill
s
b
a
sed
health
det
erminan
ts
for
DRP
s.
The
D
RP
s
tra
ini
ng
prog
ram
was
assigned
inc
ludi
ng
,
1)
a
short
cour
s
e
tra
ini
ng
(2
-
da
y
)
and
hands
-
on
tra
ini
ng
(1
-
wee
k)
foll
owed
up,
2)
field
work
for
det
erminin
g
DRP
s
(16
-
wee
k)
and
3)
an
assess
m
ent
for
det
ermining
DRP
s
in
knowledge
and
compete
nt
skill
s.
All
compl
e
te
d
data
of
25
femal
e
VH
Vs
were
ana
l
y
z
ed
with
age
of
42
.
93
y
e
ars
old
o
n
ave
r
age.
About
68%
wer
e
ag
e
high
er
th
a
n
40
y
e
ars
old
a
nd
m
ost
of
the
m
were
Par
a
rubbe
r
far
m
ers
(76%).
Mos
t
of
the
m
had
a
primar
y
educat
ion
level
(60%
)
and
al
m
ost
a
h
alf
had
m
ore
than
t
en
y
e
ars
in
V
HV
s’
servic
e
(n
=12;
48%)
.
The
ir
knowledg
e
score
s
for
de
t
ermining
DRP
s
were
12.
88
on
ave
rag
e,
in
tot
al
of
15
points
.
The
ir
over
al
l
score
s
for
skill
s
pre
sente
d
wer
e
35.
48
out
of
50
point
s
in
tot
al
.
In
conc
lusion
,
thi
s
progra
m
ca
n
enha
nc
e
VH
Vs
’
abi
li
ti
es
for
det
ermining
DRPs
for
HTN
and
D
M
pa
ti
ent
s
.
Our
findi
ngs
m
ay
cont
ribute
to
fu
ture
developm
ent
of
VH
V
s
pr
ogra
m
for
impr
oving
VH
Vs
compete
nt
skill
s
for
DRP
s c
hroni
c
dise
ase
s.
Ke
yw
or
d:
Diabetes
Drug
u
se
Healt
h
v
ol
un
te
er
Hype
rtensio
n
Copyright
©
201
7
Instit
ut
e
o
f Ad
vanc
ed
Engi
n
ee
r
ing
and
S
cienc
e
.
Al
l
rights re
serv
ed
.
Corres
pond
in
g
Aut
h
or
:
Ph
ay
on
g
T
he
pa
ksor
n
,
Trang Resea
rc
h
Ce
nter fo
r O
ccup
at
io
nal
He
al
th,
Sirin
dhorn
C
ol
le
ge
of
Publi
c
Healt
h,
Tra
ng
,
P.O. Bo
x 1
74
Trang
9200
0,
Thail
an
d.
Em
a
il
: ph
ay
ong@
sc
phtra
ng.a
c.th
1.
INTROD
U
CTION
In
T
haila
nd,
V
il
la
ge
Healt
h
Vo
l
un
te
e
rs
(VHV
s
)
a
re
play
ing
key
r
ole
in
healt
h
prom
otion
a
nd
healt
h
pr
e
ve
ntion
f
or
Thai’s
po
pu
la
ti
on
inco
r
porat
ed
with
healt
h
of
fici
al
s
for
m
or
e
than
thre
e
decad
es
.
V
H
Vs
are
recr
uited
by
th
e
healt
h
a
utho
riti
es
based
on
their
at
trib
utes
as
com
m
un
it
y
le
ader
s
a
nd
their
will
ingne
ss
to
serv
e
as
V
HV
s
.
T
hey
a
re
wor
king
cl
ose
ly
wi
th
po
pu
la
ti
ons
in
com
m
un
it
y.
A
par
t
from
healt
h
prom
otion
a
nd
edu
cat
io
n
re
ga
rd
i
ng
m
at
ern
al
and
c
hild
hea
l
th,
VHVs
ha
ve
bee
n
w
ork
ed
su
cce
ssf
ully
in
sever
al
ta
sk
s
i
n
com
m
un
ic
able
diseases
el
im
i
nation
an
d
e
ra
dicat
ion
cam
paign
s
[
1
]
-
[
2
]
.
They
al
so
pa
rtic
ipate
d
in
dru
g’
s
us
e
su
c
h
as
non
-
prescri
ption
dru
gs
,
drug
deliv
ery
or
al
co
ntr
acepti
ve
f
or
w
om
en
under
s
up
e
r
vision
of
healt
h
offici
al
s,
et
c.
VHVs
a
re
c
onti
nu
ously
trai
ne
d
f
or
stre
ng
t
he
ning
their
r
oles
in
di
ff
e
ren
t
m
od
ules
by
Healt
h
Office
s
of
t
he M
inist
ry o
f
P
ubli
c H
eal
th
[3
]
-
[
5]
.
Partic
ularly
for
the
treatm
ent
of
c
hron
ic
dise
ases,
hype
rtens
ion
(
HT
N),
dia
be
te
s
(D
M
)
pat
ie
nts
wer
e
com
m
on
ly
fo
und
t
o
us
e
m
or
e
dru
gs
tha
n
ot
her
patie
nts.
They
are
t
her
e
fore
at
a
hi
gh
e
r
ris
k
of
e
xp
e
r
ie
ncin
g
dru
g
-
relat
ed
pro
blem
s
(D
RPs).
DRPs
des
cribe
d
in
the
li
te
ratur
e
inc
lud
e
c
on
t
rain
di
cat
ion
s,
drug
–
drug
interact
ions,
a
dv
e
rse
dru
g
re
act
ion
s,
prescr
ipti
on
e
rrors,
and
no
nco
m
pliance
with
dru
g
use
[6
]
-
[
7]
.
DRP
s
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
6
, No
.
4
,
Decem
ber
20
1
7
:
283
–
287
284
fo
ll
owin
g
hospi
ta
l
discharge
are
c
omm
on
am
on
g
el
de
rly
patie
nts
us
in
g
m
ul
ti
ple
drugs
f
or
t
he
tr
eat
m
ent
of
chro
nic
diseas
es.
W
it
h
res
pe
ct
to
old
e
r
pa
ti
ents
with
c
om
or
bid
it
ie
s
a
nd
us
in
g
m
ultip
le
dru
gs
,
DR
Ps
are
associat
ed
with
a
n
inc
rease
d
risk
of
hosp
it
al
read
m
issi
ons,
m
or
bid
it
y,
a
nd
m
or
ta
li
ty
.
Discha
rg
e
of
pa
ti
ents
from
the h
ospit
al
sett
ing
to
ho
m
e care is a
no
t
her im
po
rtant ri
sk
f
act
or for
DR
Ps
[
8]
.
In
Tra
ng
stu
dy
survey
,
the
pre
vale
nce
of
D
M
and
HT
N
a
m
on
g
ad
ults
a
ged
m
or
e
than
35
ye
ars
old
was
1.6
3%
an
d
3.6
9%
(
n=
220,0
66)
f
r
om
s
creeni
ng
te
st
pro
gr
am
in
2013.
This
is
ex
pe
ct
ed
to
rise
to
highe
r
than
5%
in
20
20.
H
ow
e
ve
r,
s
pecific
popula
t
ion
s
ubgro
ups
hav
e
a
m
uch
hi
gh
e
r
prevale
nc
e
of
the
disease
than
the
po
pu
la
ti
on
as
a
whole.
T
hese
s
ubgr
oups
ha
ve
ce
rtai
n
at
tribu
te
s
or
ri
sk
facto
rs
that
ei
ther
directl
y
cause
diabetes
or
a
re
associat
ed
with
it
[9]
.
T
he
c
orrelat
ion
of
ri
sk
fact
or
s
with
dev
el
op
m
ent
of
DM
an
d
H
TN
is
nev
e
r
100%.
H
ow
e
ve
r,
the
great
er
the
num
ber
of
ris
k
facto
rs
prese
nts
in
a
n
in
div
id
ual,
th
e
gr
eat
er
t
he
c
han
c
e
of
t
hat
in
div
id
ual
de
velo
ping
or
ha
ving
DM
and
H
NT.
Co
nv
e
rsely
,
the
c
han
ce
of
a
n
as
ym
pto
m
at
ic
in
div
id
ua
l
without a
ny r
is
k fact
ors
hav
i
ng
or d
e
velo
ping
DM and
H
N
T is r
el
at
ively
low
[5
]
,
[
10]
.
On
ly
fe
w
stu
di
es
hav
e
as
ses
sed
the
ro
le
s
a
nd
ca
pacit
y
bu
il
din
gs
of
V
H
Vs
an
d
s
pecifi
c
natu
re
of
DRPs
am
on
g DM
an
d
HNT chro
nic
patie
nt
s
with
m
ulti
ple
dru
g
use
disc
ha
rg
e
d
from
ho
s
pital
in
Thail
an
d
[9
]
-
[
11]
.
I
n
orde
r
to
achieve
the
obj
ect
ives
of
t
his
stud
y,
the
auth
or
s
dev
el
oped
qu
e
sti
onna
ire
assessm
ent
s
and
assessed
know
le
dg
e
a
nd
s
kill
s
for
determ
ining
DRPs
f
or
D
M
and
H
TN
pa
ti
ents
in
sel
ect
ed
areas
co
ve
r
ing
10
district
s
of
Tra
ng
Pro
vin
ce.
The
ai
m
of
this
stud
y
was
to
assess
the
VHVs
o
n
t
heir
know
le
dg
e
a
nd
s
kill
s
f
or
determ
ining
D
RPs
for
HT
N
and
DM
patie
nt
s.
Con
se
que
ntly
,
the
su
ggest
e
d
too
l
wa
s
include
d
to
en
ha
nc
e
and
i
m
pr
ove thei
r
a
bili
ti
es to h
el
p
DM and
HT
N pati
ents
with
m
ul
ti
ple d
r
ug
us
e
discha
r
ged.
2.
RESEA
R
CH MET
HO
D
2.1.
St
ud
y
desig
n
an
d
p
op
ul
at
io
n setting
s
As
a
par
t
of
the
stud
y
on
m
od
el
de
velo
ping
for
determ
ining
DRP
s
for
DM
and
HT
N
patie
nts
in
Trang
P
rovin
c
e,
this
cr
os
s
-
s
ect
ion
al
stu
dy
was
co
nducte
d
bet
ween
Ma
rch
a
nd
Octo
be
r
2014
(8
-
m
on
ths
)
a
m
on
g
V
H
Vs
l
iving
in
te
n
dis
tric
ts
in
T
rang.
A
sam
ple
siz
e
of
36
V
H
Vs
(
3
-
4
V
HV
s/
dis
tric
t
/Heal
th
C
enter)
wer
e
rec
ru
it
ed
an
d
pa
rtic
ipate
d
i
n
this
stu
dy
.
The
par
ti
ci
pan
ts
we
re
s
el
ect
ed
based
on
str
at
ify
sam
plings
accor
ding
te
n
district
s.
O
nly
25
of
36
pa
rt
ic
ipants
(
70%
)
wer
e
c
om
pletin
g
al
l
stud
y
procedu
res
a
nd
a
ll
data
e
m
plo
ye
d for a
naly
zes
.
The
healt
h
dat
a
onli
ne
r
eco
r
ds
wer
e
acce
s
sed
a
nd
ext
rac
te
d
f
ro
m
te
n
c
orres
pondin
g
Com
m
un
i
t
y
Ho
s
pital
an
d
Healt
h
Ce
nters
.
I
n
t
otal
of
1,000
DM
a
nd
HT
N
cases
,
t
her
e
we
re
18
8
DM(
18.80%
),
352
HTN(
35.20%
),
120
DM
&
H
TN(1
2.00%),
85
HT
N
&
Hyper
li
pi
dem
ia
(H
LM)(
8.50%)
a
nd
255
DM,
H
TN
&
Othe
rs
(
25.
50%)
cl
assifi
ed
a
s
patie
nts
pa
rtic
ipate
d
a
nd
as
s
ign
e
d
as
cases
for
V
H
Vs
in
t
his
stu
dy
(a
verage
on
age
62.65
±
12.
90
ye
ars
old
;
m
al
es
=
247(24.70%
);
fem
al
es
=7
53(75.3
0%
)).
(
Table
I).
HT
N(3
5.20%)
,
12
0
DM
&
HT
N
(12.00%),
85
H
TN
&
Hyper
li
pid
em
ia
(H
LM)
(8.50%
)
a
nd
255
DM
,
HTN
&
Ot
her
s
(
25.
50%)
patie
nts
wer
e
pa
rtic
ipate
d
an
d
assigne
d
as
cases
fo
r
VHVs
in
this
stud
y
(a
ver
a
ge
on
age
62.65
±
12.
90
ye
ars
old
;
m
al
es
=
247(2
4.7
0%)
;
fem
al
es
=75
3(
75.30%
)).
The
repor
t
of
dru
g
relat
ed
pr
ob
l
e
m
s
fo
r
dia
betes
and
hype
rtensio
n
a
m
on
g
patie
nts
wer
e
prese
nt elsewhe
re
.
2.2.
Q
uesti
on
n
aire
i
nt
er
view
s
and vali
datio
ns
The
sem
i
-
structur
e
d
quest
io
nn
ai
re
inter
views
ha
ve
bee
n
dev
el
op
e
d
ac
cordin
g
to
kn
ow
le
dg
e
a
nd
sk
il
ls
based
he
al
th
determ
in
ants
for
DRPs
.
The
assig
ne
d
pro
gr
am
fo
r
trai
nin
g
DR
P
s
includi
ng,
1)
short
course
trai
ning
f
or
tw
o
days
a
nd
ha
nds
-
on
t
r
ai
nin
g
f
ollo
we
d
up
f
or
on
e
w
eek
i
n
the
c
omm
un
it
y,
2)
fiel
d
wor
k
pr
ac
ti
ci
ng
for
six
te
en
weeks
fo
r
determ
i
ning
DRPs
in
each
vill
age,
and
3)
the
evaluati
on
crit
eria
for
determ
ining
D
RPs
in
knowle
dg
e
,
sk
il
ls
an
d
com
petence.
Dev
el
op
m
ent
and
validat
io
n
of
the
to
ol
ha
ve
been
descr
i
bed
el
se
wh
e
re.
A
s
umm
ary
of
the
po
ssible
DRPs
t
ha
t
co
uld
be
ide
ntifie
d
with
th
e
chec
klist
is
s
how
n
i
n
oth
e
r publi
sh
e
d
st
ud
y.
Ther
e
wer
e
th
r
ee
cat
ego
ries
f
or
quest
io
nnai
re
intervie
ws,
includi
ng
1)
pa
ti
ent
char
t
an
d
histo
ry
—
gen
e
ral
inf
or
m
at
ion
f
or
patie
nt,
sig
n
an
d
s
ym
pto
m
,
m
edi
cat
ion
us
a
ge
a
nd
i
nd
ic
at
io
n,
et
c.
2)
qu
est
io
nn
ai
re
intervie
ws
f
or
beh
a
vioral
ass
essm
ent
and
3)
qu
e
sti
onnaire
intervie
ws
f
or
determ
ining
D
RPs.
All
pr
im
a
ry
data
for
patie
nts
we
re
c
onduct
ed
by
qu
est
i
onnair
e
inter
views
a
nd
sur
vey
at
c
omm
un
it
y
dist
rict
hosp
it
al
s
a
nd
the
n
trai
ned
HVHs
wer
e
f
ollo
we
d
up
by
fam
ily
visit
s.
The
inclusi
on
c
rite
r
ia
fo
r
case
we
re
ei
ther
H
P
or
DM
patie
nts
or
bo
t
h
to
be
inc
oncl
us
ive
by
la
bor
at
or
y
te
st
res
ults
(F
BG>
126m
g/d
l,
BP>
140/
90)
[12
]
-
[
13]
.
Using
the
c
heck
li
st
m
edicat
ion
r
e
cords,
hos
pital
discha
r
ge
prescri
ption
s
,
i
nter
view
data,
an
d
oth
e
r
re
le
van
t
inf
or
m
at
ion
w
ere
re
viewe
d
by
three
reg
is
te
red
a
nd
wel
l
-
trai
ned
c
om
m
un
it
y
ph
arm
aci
sts.
DRPs
wer
e
cat
egorized
ac
cordin
g
to
a
num
ber
of
key
it
e
m
s
us
ing
th
e
Mi
nistry
of
Publi
c
Healt
h
cl
assifi
cat
ion
s
chem
e
[12]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N:
22
52
-
8806
Abili
ti
es o
f Vi
ll
ag
e
H
e
alth
Vol
un
te
ers
in Det
e
rmin
i
ng D
r
ug
Rel
ated Pro
ble
ms
.... (Pa
rin
a N
a
P
athalu
ng
)
285
2.3.
St
ati
stic
al
a
nal
ys
is
The
data
analy
ses
we
re
der
i
ve
d
by
SPS
S
f
or
W
i
ndows
(v
e
rsion
18,
Chic
ago,
I
L,
USA)
.
Me
ans
a
nd
SD
wer
e
us
e
d
to
cha
racteri
ze
i
nclu
ding
de
scr
ipti
ve
dem
og
ra
ph
ic
c
har
act
e
risti
cs,
fr
e
qu
e
nci
es
an
d
pe
rcen
t
ages
.
The
occurre
nc
e
of
DRPs
was
cal
culat
ed
by
div
idi
ng
the
to
ta
l
nu
m
ber
of
(potenti
al
)
DRPs
by
the
num
ber
of
patie
nts.
T
he
num
ber
of
dru
gs t
aken by t
he p
at
ie
nt h
a
d
a si
gnific
ant e
ff
ect
on the
occ
urre
nce
of D
RP
s.
2.4.
Ethical
ap
r
oval
This
stu
dy
wa
s
ap
prov
e
d
by
the
et
hical
co
m
m
i
tt
ee
of
Sir
indhor
n
Coll
e
ge
of
P
ubli
c
Healt
h.
T
he
per
m
issi
on
to
cond
uct
the
st
ud
y
was
gr
a
nted
by
C
omm
u
nity
Ho
s
pital
Ph
arm
aci
sts
and
Healt
h
O
ff
ic
ia
ls
from
te
n
district
s
in
Trang
P
rovin
ce
and
par
ti
ci
pa
te
d
V
HV
s
.
A
ll
of
the
pa
rtic
ipants
we
re
cl
early
inform
ed
of
th
e
pur
po
se
of t
his stu
dy a
nd a
gr
e
ed by si
gnin
g
a
conse
nt for
m
.
3.
RESU
LT
S
A
ND AN
ALYSIS
3.1.
Quantit
ati
ve
da
t
a
T
we
nty
-
five
V
HV
s
wer
e
c
omplet
ing
al
l
pro
cedure
of
the
pro
gr
am
.
The
m
ean
age
of
the
VHVs
wa
s
42.93
ye
a
rs
old
.
M
or
e
tha
n
68%
wer
e
age
higher
tha
n
40
ye
ars
old
an
d
m
ajo
rity
of
th
e
m
wer
e
Para
rub
ber
far
m
ers
(
76
%
).
They
ha
d
pr
i
m
ary
edu
cat
io
n
le
vel
(
60
%
)
and
al
m
o
st
an
half
of
them
had
m
or
e
tha
n
t
en
ye
ar
s
in service
s
(n
=12
;
48%)
(
Ta
ble
1
).
Table
1.
Desc
riptive C
har
act
er
ist
ic
s o
f VMVs
Wh
o Pa
rtic
ipate
d
f
or D
R
Ps
in Tr
a
ng P
r
ov
i
nce
Ch
arac
teristics
No
.
Percent
S
ex
Fe
m
ale
25
1
0
0
.00
Ag
e (
y
rs)
,
m
ean (S
D)
Ran
g
e(y
rs)
,
(
m
in
-
m
a
x
)
4
2
.92
±
1
.31
30
-
59
Ag
e (
y
rs)
<3
9
40
-
49
>5
0
8
11
6
3
2
.00
4
4
.00
2
4
.00
Occup
atio
n
(
%)
Para
rub
b
er
f
ar
m
e
r
s
Own
bu
sin
ess
/self
-
e
m
p
lo
y
ed
work
e
rs
T
e
m
p
o
rary
wo
rker
s
19
3
3
7
6
.00
1
2
.00
1
2
.00
Edu
catio
n
level
Pri
m
a
r
y
Seco
n
d
ary
Ass
o
ciate/coll
eg
e
15
7
3
6
0
.00
2
8
.00
1
2
.00
Y
ears in services
(yrs)
<1
0
10
-
20
>2
0
13
10
2
5
2
.00
4
0
.00
8
.00
T
o
tal
25
1
0
0
.00
In
this
stu
dy
crit
eria
f
or
e
va
luati
on
of
V
HV
s
knowle
dge
wer
e
base
d
on
thei
r
know
le
dg
e
f
or
determ
ining
D
RPs,
treat
m
ent
,
f
ood
i
ntake,
sp
eci
al
preca
ut
ion
a
nd
rec
omm
end
at
ions
f
or
the
patie
nts
(tota
l
scor
e
=
15
po
i
nts)
wh
e
reas
s
kill
s
for
de
te
r
m
ining
DRPs
wer
e
i
nclu
ded
1)
t
heir
par
ti
ci
pation
an
d
in
volvem
ent
for
en
ha
ncin
g
DRPs
f
or
th
e
patie
nts
as
well
as
the
ski
ll
s
fo
r
inter
vi
ewin
g
on
determ
ining
DRPs
wer
e
assessed
,
2)
t
est
ing
their
knowle
dge
for
sp
eci
fical
ly
de
te
rm
ining
DRPs
f
or
DM
a
nd
HT
N,
3)
patie
nt
ou
tc
om
es
fo
cu
sed
wer
e
i
ncl
ud
e
d
decre
asi
ng
a
num
ber
of
ca
ses
f
or
DRPs
a
nd
the
qual
it
y
of
li
f
e
of
the
patie
nts,
4)
the
y
al
so
e
xp
ect
e
d
to
pr
ese
nted
their
ac
hievem
ent
by
prese
nting
an
d
en
ga
ge
m
ent
to
the
au
dience
or
assess
ors
an
d
5)
they
co
uld
pr
ovide
sel
f
-
s
upportive
gr
oup
an
d
their
le
ader
s
hip
s
kill
s
fo
r
dete
rm
ining
DRPs
(
total
score
=
10
points
eac
h).
VHVs
kn
ow
le
dg
e
ha
d
12.
88
po
i
nts
on
ave
ra
g
e
(total
=
15
po
i
nts)
that
pr
e
su
m
e
they
ha
d
hi
gh
knowle
dge
f
or
determ
ining
DRPs
for
their
assigne
d
patie
nts.
T
his
w
oul
d
be
co
rr
el
at
e
d
wit
h
their
j
ob
ex
pe
riences
f
or
a
nu
m
ber
of
ye
ars
i
n
se
rv
ic
es
(Ta
ble
2
)
.
A
no
t
her
pa
rt
of
this
st
ud
y
pr
esented
cl
assifi
cat
io
n
of
DRPs
relat
ed
to
m
edicat
ion
us
e,
i
nclu
ding
1)
patie
nt
-
relat
ed
prob
l
e
m
s
fr
om
non
-
dru
g
com
pliance
su
ch
as
non
-
us
e
ever
y
m
eal
,
abse
nce
of
a
war
e
ness
ab
ou
t
m
edication
us
e
an
d
thou
ght
the
sy
m
pto
m
s
wer
e
i
m
pr
ov
e
d,
fe
arin
g
to
side
e
ff
ect
s,
forgott
en,
fea
rin
g
to
s
yri
ng
es
for
D
M
patie
nts,
m
i
ssin
g
appointm
ent
w
it
h
physi
ci
an,
run
ning
out
of
dru
gs
befor
e
nex
t
visit
,
et
c.
2)
side
e
ff
ect
s
of
dru
g
us
e
wer
e
nausea
a
nd
vo
m
iting
(e.
g.
,
m
et
fo
rm
in),
c
ou
gh
i
ng
(e
.g.,
e
na
la
pr
il
),
relat
ed
sid
e
ef
fects
of
dru
g
us
e
(in
so
m
nia,
dizz
iness,
blur
visio
n,
pal
pitat
ion
,
et
c.
3)
dos
es
too
lo
w
w
er
e
us
in
g
dru
g
s
ensiti
vity
of
de
gen
e
rati
on
(st
orage
,
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
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8806
IJPHS
V
ol.
6
, No
.
4
,
Decem
ber
20
1
7
:
283
–
287
286
tem
per
at
ur
e
,
unf
old,
et
c.)
a
nd
re
du
ci
ng
do
se
by
them
selv
es
(t
hought
the
sym
pto
m
s
wer
e
im
pr
ove
d),
4)
double
m
edica
ti
on
us
i
ng
by
ta
king
dru
gs
over
do
se
(v
isi
t
diff
e
ren
t
hos
p
it
al
and
treatm
ent,
physi
ci
ans
)
an
d
do
s
e to
o hig
h f
ro
m
f
org
otten
and the
n repeat
ing
ta
ken dr
ugs.
In
this
stu
dy,
the
first
pri
or
it
y
fo
r
dec
reasin
g
DRPs
wa
s
involve
d
pa
rtic
ipati
on
a
nd
e
ngagem
ent
of
VHVs
inter
vie
ws
f
or
determ
ining
DRPs
.
I
n
ad
diti
on,
the
relat
ion
s
hip
s
betwee
n
V
HVs
and
patie
nts
wer
e
cl
os
el
y
since
so
m
e
of
the
m
m
ay
be
a
relat
i
ve
or
a
neig
hbor
who
we
re
li
ving
in
sim
il
ar
com
m
un
it
y
se
tt
ing
s.
They
c
ou
l
d
pr
ov
i
de
knowle
dge
a
nd
res
our
ces
as
well
as
com
m
un
ic
at
ion
th
rou
gh
thei
r
rela
ti
ons
hip
s
m
or
e
easi
ly
than
he
al
th
offici
al
s.
Re
centl
y,
the
gr
eat
er
the
acc
eptable
of
knowle
dge
a
nd
ski
ll
s
of
VHVs
sho
w
s
capab
il
it
ie
s,
th
e
great
er
t
he
e
nh
a
ncin
g
of
D
M
an
d
HTN
pa
ti
ents
for
DRP
s
[
13
]
-
[
15
]
.
Se
cond,
their
kn
owle
dge
for
determ
ining
D
PRs
was
a
ke
y
point
for
s
tren
gth
e
ning
t
heir
ro
le
s
a
nd
i
m
ple
m
entat
io
n.
T
hey
had
ski
ll
s
fo
r
determ
ining
D
RPs
f
or
relat
ively
well
e
nough
f
or
hel
ping
healt
h
offici
al
s
an
d
c
omm
un
it
y
pha
rm
ac
ist
s
on
DRPs.
E
ve
n
th
ough
their
e
ducat
ion
le
vels
w
ere
low,
they
cou
l
d
pro
vid
e
ta
ci
t
kn
owle
dge
from
their
lon
g
tim
e
exp
e
riences
.
T
hese
noti
ces
on
w
hy
V
HV
s
wer
e
acce
ptabl
e
fo
r
t
heir
w
orks
an
d
pract
ic
es
[16].
They
pr
esente
d
35.48
out
of
50
points
in
total
or
7.09
poin
t
on
aver
a
ge.
Thir
d,
this
stu
dy
fo
c
us
e
d
on
patie
nt
ou
tc
om
es
for
decr
easi
ng
DR
Ps
an
d
i
m
pr
ov
ing
the
qu
al
it
y
of
li
fe
of
patie
nts.
F
ourth,
s
el
f
-
s
upportive
gro
up
a
nd
le
ad
ersh
i
p
sk
il
ls
are
i
m
po
rtant
for
m
ai
nt
ai
nin
g
t
heir
w
ork
an
d
co
ntin
uous
ly
i
m
pr
ov
ing
DR
Ps
f
or
chro
nic
patie
nts.
Thi
s
stud
y
sho
wed
si
m
il
ar
resu
lt
s
as
oth
er
crit
eri
a
sk
il
l
s.
Ho
we
ver,
they
wer
e
low
in
pr
ese
nt
at
ion
on
their
works
by oral
pr
ese
nt
at
ion
that
wo
uld
be
c
orrelat
ed
w
it
h
t
heir
le
ve
ls of ed
ucati
on
[17
]
-
[
18]
.
Table
2.
E
val
ua
ti
on
Crit
eria
of VH
Vs K
nowl
edg
e
and
Sk
il
ls
for
DRPs
in
T
rang
Prov
i
nce
Criteria
Descripti
v
e f
o
r
ev
a
lu
atio
n
Sco
re
Mean
SD
Kn
o
wled
g
e sk
ills
Kn
o
wled
g
e of
dete
r
m
in
in
g
DRPs
1
2
.88
0
.18
I.
Participatio
n
Participatio
n
and
i
n
v
o
lv
e
m
en
t,
sk
ills f
o
r
in
terviews f
o
r
d
eter
m
in
in
g
DRPs
7
.76
0
.83
II
.
Kno
wled
g
e
Testin
g
kn
o
wled
g
e
f
o
r
d
eter
m
in
in
g
D
RPs
f
o
r
DM
an
d
H
TN
7
.60
0
.76
II
I
.
Patien
t ou
tco
m
e
Decr
easin
g
DRPs
,
q
u
ality
of
lif
e of
p
atien
ts
7
.72
0
.61
IV
.
Presen
tatio
n
Oral
p
res
en
tatio
n
techn
iq
u
es an
d
en
g
ag
e
m
en
t of
aud
ien
ces
5
.88
1
.16
V
.
Self
-
r
elian
ce
Self
-
su
p
p
o
rtive g
r
o
u
p
and
leadersh
ip
sk
ills
7
.52
0
.77
Total
3
5
.48
2
.88
3.2.
Qua
li
t
at
i
ve
d
ata
The
de
scri
ptiv
e
of
a
n
exam
ple
case
of
VHV
s
for
en
ha
ncin
g
DRPs
f
or
H
TN
patie
nt.
“Wh
e
n
on
e
of
VHVs
visit
ed
HTN
fem
al
e
patie
nt,
the
patie
nt
ha
d
65
kg
and
he
r
BP
we
re
19
0/90
m
m
Hg.
S
he
li
ke
d
to
ea
t
sal
ty
fo
od
a
nd
rar
el
y
exe
rcise.
Sh
e
has
oft
en
forgott
en
ta
kin
g
m
edici
ne.
A
f
te
r
sh
e
pa
rtic
ipate
d
in
th
e
pr
ogram
by
helpi
ng
of
VHVs,
sh
e
ha
d
hi
gh
e
r
m
otivate
d
an
d
pr
e
sented
her
pro
gr
ess
on
re
du
ci
ng
her
high
blood
pr
ess
ure.
S
he
m
ade
her
own
cal
end
a
r
an
d
note
s
for
ta
king
m
edicat
ion
s
and
f
ood
inta
ke
s
in
each
sing
l
e
day.
Sh
e
re
duced
c
on
s
um
ing
foo
d
with
le
ss
sal
t
and
inc
rease
d
consum
ing
ve
getables.
I
n
ea
ch
day,
she
sank
her
feet
on
herbal
wa
rm
water
after
finish
i
ng
her
w
ork.
S
he
can
re
du
ce
he
r
BP
t
o
160/
59
m
m
Hg
within
one
m
on
th for
pa
rtic
ipati
on
pro
gra
m
w
it
h
adv
ic
e
of VHV
s”
.
3.3.
St
ud
y
li
mi
t
at
i
on
s
This
stu
dy
has
so
m
e
lim
it
ation
s.
First,
only
a
few
of
par
ti
c
ipants
wer
e
en
ro
ll
ed
to
par
ti
c
ipate
in
this
stud
y.
It
w
ould
be
bette
r
to
re
cru
it
m
or
e
nu
m
ber
of
VHVs
for
gen
e
rall
azat
ion
the
res
ults.
Sec
ond,
wit
hin
t
he
coho
rt
of
this
stud
y
we
di
d
no
t
c
onduct
th
e
baseli
ne
or
fo
ll
ow
-
up
stu
dy
to
co
nf
irm
consi
ste
ncy
of
their
knowle
dge an
d skil
ls. Th
ir
d,
we
di
d
not ha
ve
the co
m
par
is
on
data on
knowle
dge f
or
bas
el
ine an
d p
os
t
VHVs
’
gaining;
th
us
,
cl
early
this
da
ta
deserves
fur
ther
e
valuati
on
.
H
ow
e
ve
r,
th
e
stren
gth
s
of
this
stud
y
li
e
in
it
s
represe
ntati
ve
VHVs
f
r
om
all
district
s
cov
e
rin
g
sub
j
ect
s
and
dif
fer
e
nt
m
easur
e
d
do
m
ain
s
of
DR
Ps
as
pects.
The
f
ollow
i
ng
up
an
d
s
uffici
ent
nu
m
ber
s
of
cases
ena
bl
e
the
require
d
sta
ti
sti
cal
analy
ses
to
be
pe
rform
ed.
Also
,
be
cause
of
t
he
e
xisti
ng
on
li
ne
pr
ogra
m
acce
ss,
the
data
on
m
edical
record
s
we
re
reli
able
an
d
i
nc
lusive.
To
be
use
f
ul
in
determ
ine
DRPs
on
ris
k
as
sessm
ent,
too
ls
or
quest
io
nnai
re
su
r
veys
ne
ed
to
be
exte
ns
ive
in
their a
bili
ty
to
increase
patie
nt
s at risks w
ho
li
vin
g wit
h D
M an
d
H
TN
di
seases [
19
]
-
[
20].
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N:
22
52
-
8806
Abili
ti
es o
f Vi
ll
ag
e
H
e
alth
Vol
un
te
ers
in Det
e
rmin
i
ng D
r
ug
Rel
ated Pro
ble
ms
.... (Pa
rin
a N
a
P
athalu
ng
)
287
4.
CONCL
US
I
O
N
Applyi
ng
kn
owle
dge
a
nd
s
kill
s
for
deter
m
ining
DRPs
ha
ve
se
ver
al
ad
van
ta
ges,
includi
ng
a
conve
nient,
go
od
relat
io
nship
s,
le
ss
tim
e
con
su
m
ing
an
d
c
os
t
-
e
ff
ect
ive
w
ay
fo
r
eval
uating
knowle
dge
and
sk
il
ls
on
healt
h
risks
of
DR
Ps
and
patie
nt
com
pliance;
s
pecifica
ll
y,
this
program
can
app
ly
as
a
too
l
for
enh
a
ncin
g
VHVs’
a
bili
ti
es
for
determ
ining
DRPs
f
or
HT
N
an
d
DM
pat
ie
nts.
O
ur
fin
di
ng
s
m
ay
con
tr
ibu
te
to
fu
t
ur
e
de
velo
pm
ent o
f
VH
Vs pro
gr
am
f
or im
pro
ving
VHVs
co
m
petent sk
il
ls for
DRPs c
hro
nic
diseases.
ACKN
OWLE
DGE
MENTS
The
auth
ors
w
ou
l
d
li
ke
to
thank
al
l
par
ti
ci
pa
nts,
inclu
ding
VHVs,
Com
m
un
it
y
Ho
s
pital
Ph
a
rm
aci
s
ts
and
H
eal
th
O
ffi
ci
al
s
fr
om
te
n
district
s
in
Tra
ng
P
r
ov
i
nce
f
or
their
assist
an
ce
and
p
arti
ci
pa
ti
on
s
in
this p
roject.
This st
ud
y
was
funde
d by the
Nati
on
al
Healt
h
Sec
uri
ty
O
f
fice.
REFERE
NCE
S
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Chuengsat
i
ansup
K.
and
P.
Suk
sud
,”
“
Potent
ia
ls
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deve
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nta
l
stra
te
gi
es
hea
l
th
volun
teers
in
the
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nges
,”
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oci
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eal
th
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2006.
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rs
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oti
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zi
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ai
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s
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il
la
ge
Hea
l
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Volunte
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r
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B
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lt
h
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rcu
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Control
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Village
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Prim
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te
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Drug
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m
s
ide
nti
fie
d
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m
edi
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at
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i
ews
b
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Aus
tra
li
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m
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n
ti
a
l
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rel
a
te
d
pro
ble
m
s
in
the
el
d
erly
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the
r
o
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he
comm
uni
t
y
phar
m
ac
ist
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ad
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“
Ide
n
ti
fi
cation
of
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-
r
el
a
te
d
proble
m
s
of
elderl
y
p
at
i
ent
s
d
i
scha
rge
d
from
hospita
l
,”
Pat
i
ent
Pref
Ad
.
,
vol
.
8
,
pp.
155
–
165
,
20
14
.
[9]
Tra
ng
Pro
vin
cial
Hea
l
th
Offi
ce
,
2
014
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[10]
Ngous
angsa
i
P.
S
.
P
.
and
Puttra
b
enj
apo
l
S.
,
“
A Ca
se
Stud
y
of
He
a
lt
h
Literac
y
of
Vill
ag
e
Hea
lt
h
Volunteers
,”
Isan J
Pharm Sc
i
.
,
vo
l.
9
,
pp
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82
-
7
,
201
4
.
[11]
Kom
wong
D.
S
.
T.
,
“
Fac
tors
aff
ec
t
ing
drug
use
beha
vio
rs
of
vi
llage
he
al
th
vo
lun
te
ers
,”
Thai
Pha
rm
Healt
h
Sci
.
J
.
,
vol/
issue:
7(3)
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p
p.
121
-
6
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2012
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[12]
Depa
rt
m
ent
of
Hea
lt
h
Services
Support
,
“
Gui
del
in
e
on
H
ea
l
t
h
Prom
oti
on
an
d
Beha
v
iora
l
R
isk
Reduction
o
f
Disea
se
Contro
l for Vil
l
age Hea
l
t
h
Vo
lunt
e
ers
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”
Ministr
y
of
Publ
ic
He
al
th
,
2014
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[13]
Te
int
h
avor
n
V
.
,
“
Surveil
la
nc
e,
Control
and
Pre
vent
ion
S
y
s
t
y
e
m
of
DM
and
H
T
in
Thaila
nd
:
Policy
in
Ac
ti
o
n
,”
Depa
rtment
o
f
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ea
l
th
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ce
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up
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istr
y
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ani
tkun
N
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e
t al.
,
“
Buil
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uity
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chr
oni
c
d
isea
se
m
ana
g
ement
in
Thail
and:
A
wholes
y
stem
provinc
i
al
tri
a
l
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f
s
y
stematic,
pro
-
ac
t
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Il
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.
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,
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ven
ti
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n
educat
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pro
gra
m
for
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he
al
th
c
ar
e
workers i
n
Tha
i
l
and
,”
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alt
h
,
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p
p.
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the
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al
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,
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lt
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uca
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Multi
-
Profess
iona
l
In
te
rve
n
ti
on
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Tr
ai
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r
Ongoing
Volunte
er
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base
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Com
m
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lt
h
Program
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e
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st
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iland
,”
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Hea
lth
li
terac
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ll
ag
e
health
vol
unte
ers
in
Mun
ic
ip
al
iti
y
,
Nakh
on
Rat
ch
asima
,
Tha
iland
,”
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Pub
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vo
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issue:
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[18]
Hersh L
.
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et
a
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,
“
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lt
h
L
itera
c
y
in
Prim
ar
y
Care Prac
t
ic
e
,”
Am
F
am P
hysician
,
v
ol/
issue:
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,
p
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-
24
,
2015
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[19]
Depa
rtment
of
Hea
lt
h
Servi
ce
s
Support
,
“
Mau
nal
for
Com
m
u
nity
He
al
th
Ma
nage
m
ent
Lead
er
for
Inte
gra
t
e
d
T
ambol
Mana
g
e
m
ent
in
H
ea
l
th Care
,
”
Min
istr
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[20]
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e
t
al
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,
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Mana
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em
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or
chr
oni
c
dise
a
ses:
a
ca
se
stu
d
y
of
di
abe
t
es
an
d
h
y
p
ertension
,”
Hea
lt
h
S
y
st
em Re
sea
rch
Insti
tut
e
,
2010.
Evaluation Warning : The document was created with Spire.PDF for Python.