Drug and Therapeutics Committees - A Practical Guide
(2003; 155 pages) [French] [Spanish]

Table of Contents

	Acronyms and abbreviations
	Preface
	1. Introduction
		1.1 Why are drug and therapeutics committees (DTCs) needed?
		1.2 Goals and objectives of the DTC
		1.3 Functions of the DTC
		1.4 Role of the DTC in the drug management cycle
	2.Structure and organization of a drug and therapeutics committee
		2.1 Principles in setting up a DTC
		2.2 Steps in setting up and managing the DTC
		Annex 2.1 Example of a declaration of interest form
		Annex 2.2 Model terms of reference for a DTC in Zimbabwe
		Annex 2.3 Example of a mandate for a DTC: excerpts from the Zimbabwe National Drug Policy 1998
	3. Managing the formulary process
		3.1 The formulary process
		3.2 The formulary list (essential medicines list)
		3.3 Formulary manual
		3.4 Standard treatment guidelines (STGs)
		Annex 3.1 Application forms to be filled in by applicants when applying for a new drug to be added to the hospital formulary list
		Annex 3.2 Drug information included in a comprehensive formulary
	4.Assessing new medicines
		4.1 The need for critical assessment of new medicines
		4.2 Sources of information to assess new medicines
		4.3 Assessing the efficacy and safety of new medicines from the literature
		4.4 Measuring and comparing clinical treatment outcomes
		4.5 Measuring and comparing drug costs
		Annex 4.1 Sources of information
		Annex 4.2 Checklist to detect common problems encountered in articles
	5.Ensuring medicine safety and quality
		5.1 The need for ensuring medicine safety and quality
		5.2 Monitoring and addressing medication errors
		5.3 Monitoring and ensuring medicine quality
		5.4 Safety of medicines
		Annex 5.1 Basic analytical medicine tests
		Annex 5.2 Examples of adverse drug reaction reporting (ADR) reporting forms
		Annex 5.3 Naranjo algorithm for assessing the causality of an ADR
	6.Tools to investigate the use of medicines
		6.1 Stepwise approach to investigating the use of medicines
		6.2 Analysis of aggregate medicine use data
		6.3 WHO/INRUD drug use indicators for health facilities
		6.4 Qualitative methods to investigate causes of problems of medicine use
		6.5 Drug use evaluation (DUE) (drug utilization review)
		Annex 6.1 Defined daily doses (DDD) of some common medicines
		Annex 6.2 DUE criteria on data collection form for amikacin
	7.Promoting the rational use of medicines
		7.1 Changing a medicine use problem
		7.2 Educational strategies
		7.3 Managerial strategies
		7.4 Regulatory strategies
		7.5 Choosing an intervention
		7.6 Evaluating interventions
		Annex 7.1 Examples of structured order forms from a hospital in Nepal
	8.Antimicrobials and injections
		8.1 Antimicrobials, resistance and infection control
		8.2 Safe and appropriate use of injections
	9. Getting started
		9.1 Addressing the problem
		9.2 Stepwise approach to starting a DTC where none exists
		9.3 Revitalizing non-functioning DTCs
		9.4 Using this manual to solve problems
	Glossary¹
	References
	Further reading
	Useful addresses and websites
	Back cover

Drug and Therapeutics Committees - A Practical Guide

WHO/EDM/PAR/2004.1

World Health Organization
Department of Essential Drugs and Medicines Policy
Geneva, Switzerland

In collaboration with

Management Sciences for Health
Center for Pharmaceutical Management
Rational Pharmaceutical Management Program
Arlington, Virginia, USA

Authors

Kathleen Holloway¹ (Editor)
Terry Green²

with contributions from: Edelisa Carandang,¹ Hans Hogerzeil,¹ Richard Laing,³ David Lee,²

The text was reviewed by: John Chalker,² Mary Couper,¹ Andrew Creese,¹ Marthe Everard,¹ Anna Paula di Felici,⁴ Chris Forshaw,⁵ David Henry,⁶ Yvan Hutin,⁷ Sabine Kopp,¹ Souly Phanouvong,⁸ Clive Ondari,¹ Lembit Rago,¹ Marcus Reidenberg,⁹ Budiono Santoso,¹⁰ Anthony Savelli² and Rosamund Williams.⁴

¹ Department of Essential Drugs and Medicines Policy (EDM), World Health Organization, Geneva, Switzerland

² Management Sciences for Health (MSH), Washington DC, USA*

³ Department of International Health, Boston University, Boston, Massachusetts, USA

⁴ Department of Communicable Disease Surveillance and Response, World Health Organization, Geneva, Switzerland

⁵ Uganda Health Sector Programme Support, Danida, Kampala, Uganda

⁶ Department of Clinical Pharmacology, University of Newcastle, New South Wales, Australia

⁷ Safe Injection Global Network, Department of Blood Safety and Clinical Technology, World Health Organization, Geneva, Switzerland

⁸ Global Assistance Initiatives, United States Pharmacopeia, Maryland, USA

⁹ Division of Clinical Pharmacology, Weill Medical College of Cornell University, New York, USA

¹⁰ Regional Office for the Western Pacific, World Health Organization, Manila, the Philippines

* The MSH Rational Pharmaceutical Management Plus Program is supported by the U.S. Agency for International Development, under the terms of cooperative agreement number HRN-A-00-00-00016-00.

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use.