Pharmacy and Therapeutic committee: goals, organisation, functions, and importance

Introduction to Pharmacy and Therapeutic committee

The Pharmacy and Therapeutic Committee or what is also called the Drug and Therapeutics Committee is an advisory body responsible for developing, managing, updating and administrating the formulary system of health facilities. It is composed of physicians (prescribers), pharmacists, nurses, administrators and other health care professionals and staff who participate in the medication use process.

Why pharmacy and Therapeutic committee is needed in health facilities

Essential medicines are one of the most cost-effective ways of saving lives and improving health. Essential medicines constitute 20-40% of health budgets in many developing countries; increasing costs and lack of resources often result in public health systems being unable to procure sufficient medicines to meet patients demand.
In a health facility where there is no organized body such as the Pharmacy and Therapeutic Committee committee, there is usually the following:

1. Poor selection of medicines without consideration for relative efficacy, cost-effectiveness or local availability.

2. Inefficient procurement practices, resulting in non-availability, inadequate quality, wastage or use o unnecessarily expensive medicines.

3. Prescribing not in accordance with standard treatment protocols

4. Poor dispensing practice resulting in medication errors and patients’ lack of knowledge about dosing schedules.

5. Patients not adhering to dosing schedules and treatment advice.

The above constitute areas of inefficiency and drug use problems in health faculties. Inefficient use of medicines impacts on the safety and quality of therapeutic care and wastes resources.
According to WHO in 1985,
Rational drug use requires that the patients receive drugs appropriate to their clinical needs in doses that meet their individual requirements (right dose, right intervals and right duration). These drugs must be of acceptable quality, and available and affordable, at the lowest cost to patients and community.
When the use of medicines is not accordance with this definition, there are often undesirable health and /or economic outcome. Such outcome includes:

• Insufficient therapeutic effect
• Adverse drug reaction
• Preventable side-effects and interaction from medicine
• Increasing resistance of bacterial pathogens to antimicrobial medicines
• Prolonged hospital admissions, which are expensive

Some inefficiencies result from lack of an effective forum that brings together pharmacists, clinicians and administrators to balance the demand for quality care with financial constraints. There may be tension between prescribers and financial managers about which medicines should be available for what problems. Pharmacy and Therapeutic Committee are a forum to bring together all stakeholders involved in decisions about drug use.
Pharmacy and Therapeutic Committee committee may exist at any level within the health-care system – at Local Government level (overseeing primary health-care facilities) in hospitals, or at the national level.
In developed countries hospital Pharmacy and Therapeutic CommitteeC have been shown to be very effective in safeguarding and promoting efficient and rational use of medicines.

Goals and objectives of Pharmacy and Therapeutic committee

The goal of a Pharmacy and Therapeutic CommitteeC is to ensure that patients are provided with the best possible cost effective and quality of care through determining what medicines will be available, at what cost, and how they will be used.
In order to achieve this goal, a Pharmacy and Therapeutic Committee will have the following objectives:

• They are to develop and implement an efficient and cost-effective formulary system which includes consistent standard treatment protocols, a formulary list and formulary manual.

• The committee should ensure that only efficacious, safe, cost effective and good quality medicines are used

• Also, they should ensure the best possible drug safety through monitoring, evaluating and thereby preventing as far as possible, adverse drug reactions (ADRs) and medication errors

• They are to develop and implement interventions to improve medicine use by prescribers, dispensers and patients; this will require the investigation and monitoring of medicine use

Functions of Pharmacy and Therapeutic Committee

• Providing advice on all aspect of drug management including investigational drugs.

• Developing drug policies

• Evaluating and selecting drugs for the formulary list

• Developing (or adapting) and implementing standard treatment guidelines

• Assessing drug use to identify problems(MUE)

• Conducting inventions to improve drug use

• Managing erase drug reactions and medication errors

• Informing all staff members about drug use issues, policies and decisions

Organisation and operation of Pharmacy and Therapeutic Committee

While the composition and operation of the Pharmacy and Therapeutic Committee committee might vary among specific practice sites, the following generally will apply:

1. The pharmacy and Therapeutic Committee committee should be composed of at least the following voting members: physicians, pharmacists, nurses, administrators, quality-assurance coordinators, and others as appropriate. The size of the committee may vary depending on the scope of services provided by the organization. Committee members should be appointed by a governing unit or authorized official of the organized medical staff.

2. A chairperson from among the physician representatives should be appointed. A pharmacist should be designated as secretary.

3. They should meet regularly, at least six times per year, and more often when necessary.

4. The committee should invite to its meetings, persons within or outside the organization who can contribute specialized or unique knowledge, skills, and judgments.

5. An agenda and supplementary materials (including minutes of the previous meeting) should be prepared by the secretary and submitted to the committee members in sufficient time before each meeting, for them to review the material properly.

6. The minutes of the committee meeting should be prepared by the secretary and maintained in the permanent records of the organization.

7. Recommendations of the committee should be presented to the medical staff or its appropriate committee for adoption or recommendation.

8. Liaison with other organizational committees concerned with drug use should be maintained.

9. Actions of the committee should be routinely communicated to the various health-care personnel involved in the care of the patient.

10. The committee should be organized and operated in a manner that ensures the objectivity and credibility of its recommendations. The committee should establish a conflict of interest policy with respect to committee recommendations and actions.

11. In formulating drug use policies for the organization, the committee should be attentive to the content and changes in pertinent guidelines and policies of professional organizations and standards-setting bodies such as health professional bodies, governmental agencies, and others as appropriate.