Performance of Pharmacy and Therapeutics Committees of Public Hospitals in Rural ThailandA. Umnuaypornlert and N. Kitikannakorn*
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Pharmacy and Therapeutics Committee (PTC) is a group of multidisciplinary professionals within a hospital, responsible for managing an effective drug inventory, control and review of rational drug use and drug costs. Hospital PTCs are supervised by the Thai Ministry of Public Health. We would assess their effectiveness and, identify short-comings for which we offer solutions to improve their performance. The survey was focused on seven public hospitals in lower northern region of rural Thailand, forming an alliance and includes a university teaching unit. Three key PTC participants from each hospital were interviewed face-to-face using a semi-structured guide. Triangulation and content analysis were used for data analysis. PTC members appreciated the importance of their roles, functions and particularly the importance of effective drug selection for the hospital formulary. However, PTC performance was compromised by; over-stretched committee staffs, inadequate budgetary considerations, personal and professional conflicts and prejudices, poor communication and performance monitoring, erratic national directives, and lack of standard criteria for drug selection. We suggest that the whole system be over-hauled via management of human resources, committee membership, and communication, creating tools for effective decision-making for rational drug selection, staff training and integrating PTC and rational drug use into medical curricular, and clear and consistent national regulation. Clearly, PTC effectiveness fell well short of the WHO recommendations. Although cost containment is a major issue, there are numerous cost-neutral changes which could improve PTC operation, effectiveness and which ultimately strengthens patient treatment.
Keyword:
PTC, Performance, Thailand, Public hospitals
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