K Alam, S Palaian
K Alam, S Palaian. Drug and Therapeutics Committee in Manipal Teaching Hospital, Pokhara, Nepal. The Internet Journal of Pharmacology. 2009 Volume 9 Number 1.
Drug use problems are common worldwide. Nepal is a developing country with several drug use problems. The Drug and Therapeutics committee (DTC) in Manipal Teaching Hospital (MTH) has been playing a vital role in promoting rational use of medicines in the hospital. The DTC has banned several irrational fixed dose combinations and formulated several guidance regarding safe and effective use of medicines. The DTC in MTH has proven the importance of DTCs in developing countries like Nepal in improving rational use of medicines in hospitals settings.
Irrational drug use is a common problem worldwide. In Nepal there are several drug use problems. Some of them include unavailability of essential medicines, irrational prescribing and dispensing, adverse drug reactions, misuse of antibiotics etc. 1,2,3,4,5,6 The American Society of Hospital Pharmacist (ASHP) defines Drug and Therapeutics Committee (DTC) as the committee that evaluates the clinical use of drugs, develop policies for managing drug use, and administration, and manages the formulary system.7 In a hospital, DTC can play vital role in optimization of rational use of medicines.
The concept of DTC is not well developed in Nepal, a developing country in South Asia. The Management Sciences for Health (MSH) has taken an initiative in spreading the concept of DTC in the developing counties. MSH provided DTC training in more than ten countries including Nepal. In Nepal, the DTC training was conducted by the MSH during December 2001 in collaboration with the World Health Organization (WHO). Manipal Teaching Hospital (MTH), the teaching hospital of the Manipal Colleeg of Medical Sciences (MCOMS) is a pioneer in hospital pharmacy activities in Nepal and has a well functional DTC. This article provides the overview of the DTC at MTH, its functions, achievements and also provides an overview of a recently held DTC meeting.
Establishment of Drug and Therapeutics Committee and its organization: The DTC was initially established in the year 2001 in MTH. But it was not proactive and hence revitalized during the year 2004. The committee consists of a chairman, a member secretary and members from different departments. The organizational structure of the DTC is shown in figure 1.
Operation of DTC in Manipal Teaching Hospital: The committee members meet once in three months. Prior to the meeting a circular from the DTC Chairman is issued to all the members. The Chairman in discussion with the Member secretary decides the date, time and venue for the meeting. The Member secretary prepares the agenda and circulates to all members well in advance prior to DTC meeting. The prepared agenda are discussed in the meeting and the decisions made during the meeting are recommended for implementation.
Achievements of the DTC in the past: 8, 9 Few achievements of the DTC in the past are listed below.
DTC meeting held on 11th July 2008: The recent DTC meeting was held on 11th July 2008. The meeting was preceded with Dean’s remarks and remarks from the DTC Chairman. Agenda discussed in the meeting were
The meeting was followed by a presentation by the Hospital Director on the ‘Importance and Functions of Drug and Therapeutics Committee’. The contents of the presentation included the need for DTC, Goal and objectives of DTC, DTC structure and organization of DTC and its basic functions.
In a country like Nepal with numerous drug use problems, the role of DTC is significant. Our experience clearly signifies that a DTC in a hospital can play a vital role in promoting rational use of medicines in developing countries like Nepal.