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Pilot drug and therapeutic committee program in Sierra Leone: a descriptive mixed method study.

Abstract：

INTRODUCTION:Irrational medicine use is a global crisis, but incidences are proportionately higher in low and middle-income countries like Sierra Leone. This study explores the structure, functions, and challenges of Drug and Therapeutics Committees (DTC) an intervention towards irrational medicines use recently piloted in Sierra Leone. METHOD:A two-phase mixed-method study design was used in this study. Firstly, a cross-sectional survey was conducted on all pharmacists who have worked for at least one year in DTC piloted hospitals, using an online questionnaire to assess DTC's structure, indicators, and challenges. In phase two, all eligible pharmacists were invited for a semi-structured online interview using Whatapps messaging application to get deeper insights into the key issues that emerged from the survey; however, only five of the seven consented to participate. MS Excel 2019 and NVivo version 12 were respectively used for data management and analysis. RESULTS:A total of six survey responses and five interviews were included in the analysis. Participants are pharmacists from the seven hospitals in Sierra Leone, where DTC was piloted. Most DTC are comprised of a minimum of ten members consisting of both medical and hospital administrative staff. The main functions of DTC are ensuring rational medicines use, monitoring, and reporting adverse drug reactions. All seven hospitals with established pilot DTC have different subcommittees operating at varying functionality levels, ranging from effective to nonfunctional. The main challenges in DTC functions and maintenance are funding (n=6), DTC decision implementation (n=4), and unmotivated members (n=4). Strategies suggested to improve DTC at public hospitals and nation-wide include; resource allocation, monitoring, and evaluating DTC functions and its members' capacity building. CONCLUSION:DTC present a compelling opportunity towards achieving rational medicines use at the hospital level in Sierra Leone. Nonetheless, the lack of funding and operational resources are significant limitations that must be noted by policymakers before expanding DTC programs to other hospitals in Sierra Leone.

journal_name

Br J Clin Pharmacol

journal_title

British journal of clinical pharmacology

authors

Kabba JA,Koroma MM,James PB,Kitchen C,Xu S,Chang J,Saeed A,Malik UR,Jiang M,Fang Y

doi

10.1111/bcp.14716

subject

Has Abstract

pub_date

2021-01-04 00:00:00

eissn

0306-5251

issn

1365-2125

pub_type

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Pilot drug and therapeutic committee program in Sierra Leone: a descriptive mixed method study.