Drug and therapeutics committees in Nigeria: evaluation of scope and functionality

Abstract

Introduction: Inappropriate use of medicines remains a problem, with consequences including increasing adverse drug reactions (ADRs) and prolonged hospitalizations. The Essential Medicines List and Drug and Therapeutics Committees (DTCs) are accepted initiatives to promote the rational use of medicines. However, little is known about DTC activities in Nigeria, the most populous African country. Areas covered: A cross-sectional questionnaire-based study was conducted among senior pharmacists, consultant physicians and clinical pharmacologists in 12 leading tertiary healthcare facilities across Nigeria. Expert commentary: Six (50%, 6/12) healthcare facilities had existing DTCs with three (50%) having a subcommittee on antimicrobials. 75% had infection control committees, with presence even in centres without DTCs. Chairpersons and secretaries of the DTCs were predominantly physicians (83.3%) and pharmacists (100%) respectively. Hospital formularies were available in five facilities with DTCs, while one facility without a DTC had an Essential Medicines Committee responsible for developing and updating the hospital formulary. The evaluation of ADRs was undertaken by pharmacovigilance units in nine facilities. Overall, DTCs were present in only half of the surveyed facilities and most were performing their statutory functions sub-optimally. The functioning of DTCs can be improved through government directives and mechanisms for continuous evaluation of activities.

Drug and therapeutics committees in Jordanian hospitals: a nation-wide survey of organization, activities, and drug selection procedures

“…A questionnaire was developed based on previous research 2,6-9. The questionnaire which was pretested consisted of five main parts of closed-ended questions.…”

“…Drug and therapeutics committees (DTCs) are presented in the hospitals to improve prescribing and dispensing processes of medicines. Their importance appears in different aspects such as drug selection process, cost-effectiveness, and control of drug losses 1,2. Altogether, DTCs have shown an important role in promoting, controlling and educating activities of rational drug use.…”

Formulary Management Activities and Practice Implications Among Public Sector Hospital Pharmaceutical and Therapeutics Committees in a South African Province

“…Similarly, Martin et al (Martin et al, 2003) and Jenkings et al (Jenkings and Barber, 2004) found in the UK that formulary decisions were based on a cluster of factors including the clinical benefits and the degree of certainty, with local knowledge also used in the UK (Martin et al, 2003;Jenkings and Barber, 2004). This is very different to the situation in some other sub-Saharan African countries where there is very variable PTC activities even among tertiary hospitals; however, this is not universal (Directorate of Pharmacy Services, 2012; Office of Director of Pharmaceutical Services (ODPS) Ministry of Health Ghana, 2015; Ashigbie et al, 2016;Mudenda et al, 2016;Fadare et al, 2018b;Anand Paramadhas et al, 2019).…”

“…The selection of medicines that are available in the public healthcare sector currently takes place through the National Essential Medicines List Committee (NEMLC) as well as provincial and facility based PTCs (Meyer et al, 2017;Republic of South Africa, 2018). Two essential tasks of PTCs within the public healthcare system are to develop and revise institutional STGs (usually adapted from national guidelines) and to maintain an institutional formulary, based on the national EML (Laing et al, 2001;Holloway and Green, 2003;Fadare et al, 2018b). The formulary development process follows a hierarchal approach according to the level of care, as outlined in the National PTC guidelines (South African National Department of Health, 2019).…”

Reported needs of information resources, research tools, connectivity and infrastructure among African Pharmacological Scientists to improve future patient care and health

“…In addition, the irrational use of medicines, and its consequences, are a growing challenge across Africa [7,35]. This has already resulted in a number of research activities including documenting the existence and functionality of drug and therapeutic committees across African countries, documenting pharmacovigilance activties among hospitals with the aim of establishing pertinent programmes to address current concerns including the over reliance on pharmaceutical companies for information on medicines [36][37][38][39][40][41], as well as the current state of antimicrobial stewardship programmes as a basis for developing programmes to improve the future use of antimicrobials in Africa given current concerns [42][43][44]. Such activities should help to reduce AMR rates, adverse drug reactions and associated increased hospitalization rates and death, and unaffordable costs of medicines among a population that predominantly pays 'out of pocket'.…”