A Qualitative Study on the Practice Patterns of Pharmacies Engaged in the Common Illness Project in Thailand

Background Thailand’s Common Illness (CI) Project—launched in 2023 by the National Health Security Office (NHSO) and the Pharmacy Council—integrates accredited community pharmacies into primary care to manage 32 minor ailments, aiming to improve access and relieve hospital crowding amid universal health coverage (UHC). ^1,2 Empirical evidence on real-world implementation and system barriers remains limited. Methods We undertook a qualitative descriptive study across 13 health regions (March–June 2025). Fourteen licensed pharmacists from CI-accredited pharmacies were purposively sampled to ensure diversity in geography, ownership model, and experience. Semi-structured online interviews (45–60 minutes) explored workflow, supply management, barriers, and perceived impacts. Audio was transcribed verbatim in Thai and analysed using inductive content analysis guided by COREQ. ³ Three analysts coded independently, compared matrices, and resolved discrepancies by consensus. English translations of verbatim quotes underwent back-translation. Results Pharmacies consistently performed core steps—eligibility verification, ID authentication, history-taking against 32 conditions, A-MED documentation, counselling/dispensing, day-3 follow-up, and claim submission—yet varied in supplementary practices (proactive patient explanation, supplementary record forms, photo/signature confirmation, risk-factor recording, systematic follow-up documentation). Barriers clustered at system (A-MED glitches, ambiguous rules, claim delays), patient (misconceptions, antibiotic expectations), pharmacy (equipment, staffing, workload), and financing (appeals, tax uncertainty). Perceived impacts included improved access (especially for low-income groups), enhanced professional identity, and reduced hospital burden, with administrative workload as a trade-off. We propose a standardised workflow to harmonise delivery. Conclusions The CI Project demonstrates the feasibility of pharmacy-based primary care under UHC, but quality and equity would benefit from national SOPs, digital supports, and monitoring incentives that institutionalise follow-up and documentation.