Promoting Rational Use of Medicines: Core Components - WHO Policy Perspectives on Medicines, No. 005, September 2002
(2002; 6 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentDefinition of rational use of medicines
View the documentThe problem of irrational use
View the documentAssessing the problem of irrational use
View the documentWorking towards rational use of medicines
Close this folderCore policies to promote more rational use of medicines
View the document1. A mandated multi-disciplinary national body to coordinate medicine use policies
View the document2. Clinical guidelines
View the document3. Essential medicines list based on treatments of choice
View the document4. Drugs and therapeutics committees in districts and hospitals
View the document5. Problem-based training in pharmacotherapy in undergraduate curricula
View the document6. Continuing in-service medical education as a licensure requirement
View the document7. Supervision, audit and feedback
View the document8. Independent medicine information
View the document9. Public education about medicines
View the document10. Avoidance of perverse financial incentives
View the document11. Appropriate and enforced regulation
View the document12. Sufficient government expenditure to ensure availability of medicines and staff
View the documentKey documents
View the documentContacts at WHO Headquarters

4. Drugs and therapeutics committees in districts and hospitals

A drugs and therapeutics committee (DTC), also called a pharmacy and therapeutics committee, is a committee designated to ensure the safe and effective use of medicines in the facility or area under its jurisdiction, Such committees are well-established in industrial countries as a successful way of promoting more rational, cost-effective use of medicines in hospitals (Box 5). Governments may encourage hospitals to have DTCs by making it an accreditation requirement to various professional societies. DTC members should represent all the major specialities and the administration; they should also be independent and declare any conflict of interest. A senior doctor would usually be the chairperson and the chief pharmacist, the secretary.

Factors critical to success include: clear objectives; a firm mandate; support by the senior hospital management; transparency; wide representation; technical competence; a multidisciplinary approach; and sufficient resources to implement the DTC's decisions.

Box 5 Responsibilities of a drugs and therapeutics committee

• developing, adapting, or adopting clinical guidelines for the health institution or district;

• selecting cost-effective and safe medicines (hospital/ district drug formulary);

• implementing and evaluating strategies to improve medicine use (including drug use evaluation, and liaison with antibiotic and infection control committees);

• providing on-going staff education (training and printed materials);

• controlling access to staff by the pharmaceutical industry with its promotional activities;

• monitoring and taking action to prevent adverse drug reactions and medication errors;

• providing advice about other drug management issues, such as quality and expenditure.

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