Facilitators and challenges to the integration of herbal medicine in Thailand: A qualitative study of hospital stakeholders’ perspectives

Despite efforts to integrate herbal medicine (HM) with modern pharmaceuticals into the Thai healthcare systems there have been noted inconsistencies and challenges to date. This study explored the barriers and facilitators related to the integration of herbal medicine within Thai hospital systems from the perspective of key stakeholders within the hospital system. Qualitative semi-structured interviews were conducted with twenty stakeholders from six hospitals specializing in traditional Thai medicine. A triangulated approach was integrated in terms of the different disciplines represented among the stakeholders and the expertise of the researchers. Interview data were digitally recorded, transcribed, and analyzed using the ATLAS.ti software. Thematic analysis was performed using a hybrid deductive-inductive approach to identify key themes. Two themes were generated from the analysis including: factors facilitating sustainable HM practices and barriers to implementing HM practice . Key facilitating factors consisted of strong leadership support, effective multidisciplinary collaboration, active community engagement, documentation of successful HM cases, and financial support for hospitals to function as collaborative research and training centers. Barriers included: inadequate efficacy and safety data; lack of standardized pricing; public misconceptions; and lack of standardized education and guidelines in medical schools and hospital settings. The barriers and facilitators identified in this study highlight the need for ongoing collaboration between various health care providers involved in prescribing and assessing HM in the hospital setting. The findings also suggest that enhanced support and collaboration with government agencies and policy leaders will be needed to address the need for additional resource allocation for evidenced based research and its dissemination among the public and healthcare providers. These findings can inform efforts in Thailand and also countries in Southeast Asia who are facing similar challenges with balancing the integration of HM into their healthcare system. Future research is needed to determine best practices and policy development. • The study identified key factors influencing the integration of herbal medicines in hospital systems, encompassing both practice-driven enablers and barriers to implementation. A strong commitment to partnerships at the leadership level among healthcare professionals, coupled with active engagement of prospective communities, emerged as critical elements for effective implementation planning. • Enhancing public health communication regarding current research on HM efficacy can support sustainable practices. • Significant barriers to the integration of HM into the health care system will require added national level support for research that can illuminate and standardize HM prescription practices and dissemination of findings to the public and healthcare providers.