ABSTRACT
Objective: Pharmacy and Therapeutic Committee (PTC) is required for the effective running of a hospital. In the beginning, there was no such concept of drug committee, but with the advent of time, the need for an effective PTC started increasing. In the PTC, the pharmacist, physicians and nurses play an important role, in addition to the presence of an administrative. This study aims to explore the importance of having effective meetings organization and management of PTC at Ministry of Health (MOH) hospitals in Saudi Arabia. The purpose of this study was to explore the meetings organization and management of PTC at MOH hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part consisted of 93 questions divided into four domains: Domain 1: the scope, structure and responsibilities; domain 2: the formulary management system; domain 3: evaluation of drug formulary and decision-making; and domain 4: organization and management of committee meetings. This questionnaire was prepared in an electronic format and was distributed all drug information centers at MOH hospitals. It analyzed organization and management of committee meetings through Survey Monkey system. Results: A total of 50 drug information centers responded to the questionnaire (100% response rate). The person leads the discussion in PTC was a Chairman of the Committee (29 (58%)), Chief of Pharmacy (13 (26%)) and Director of Drug Information (3 (6%)). The number of scheduled meetings per year (1–4) was 18 (36%) per hospital with a duration (1-2 hrs) at 48 (96%). Most of discussions were related to medications of infectious diseases (26 (52%)) and cardiovascular diseases (21 (42%)). Most of the challenging recommendations that needed implementation was a lack of resources (37 (74%)), lack of hospital administrator support (23 (46%)) and lack of pharmacist role (18 (36%)). Conclusion: The PTC is a demanding scientific resource and administrative support. Total quality management system, workload analysis, positive outcomes of PTC were lacking. Special education and training needs to be provided to all the healthcare providers with hospital administrator’s support.
ABSTRACT
Objective: Ministry of Health (MOH) hospitals in Saudi Arabia should develop, organize and administer a formulary system that follows the principles to optimize patient care by ensuring access to clinically appropriate, safe and cost-effective medications. This can be achieved through the Pharmacy and Therapeutic Committee’s (PTC) role in the evaluation of hospital’s drug formulary and decision-making. The primary purposes of the PTC are policy development, communication and education and formulary management. Therefore, in this study, we aimed to explore the hospital drug formulary evaluation and decision-making at MOH hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part consisted on 93 questions divided into four domains. An electronic survey was distributed to all drug information centers at MOH hospitals and analyzed the evaluation of drug formulary and decision-making through the Survey Monkey system. Results: A total of 50 drug information centers responded to the questionnaire (100%). Restricted drug usage (3.88), new drug entities (3.74), new dosage form (3.6) and new strength (3.6) were the majority of the requests for inclusion in the formulary. A total of 1-3 medications were evaluated monthly by the PTC at 41 (82%) hospitals. Most of the healthcare providers were allowed to request for the addition or deletion of medications: PTC members 38 (76%), attending medical staff 35 (70%), pharmacy staff 10 (20%) and formulary subcommittees 10 (20%). The formal economic analysis of the drug formulary revision was rarely or never conducted at 26 (42%) hospitals. The responsible person for the economic evaluation was drug information pharmacist (21 (42%)), pharmacy department (nonspecific) (17 (34%)) and the pharmacy and medical department (14 (28%)). Conclusion: Evaluation of hospital’s drug formulary and decision-making was not adequate at the majority of the hospitals. Education and training about drug evaluation with an emphasis on cost analysis and impact are mandatory. An electronic addition new medications with close formulary is required with close monitoring for all MOH hospitals in Saudi Arabia.
ABSTRACT
Objective: Formulary management is an integrated patient care process which enables physicians, pharmacists and other healthcare professionals to work together to promote clinically sound cost-effective medication therapy and positive therapeutic outcomes. Effective use of healthcare resources can minimize overall medical costs, improve patient access to more affordable care and provide an improved quality of life. A formulary not only includes a list of medications and medication-associated products but also includes medication-use policies, important ancillary drug information, decision support tools and organizational guidelines. Therefore, in this study, we aimed to provide the guiding principles for the Formulary Management System at Ministry of Health (MOH) hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of Pharmacy and Therapeutic Committee at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part contained 93 questions divided into four domains. The scope, structure and responsibilities, the formulary management system, the evaluation of drug formulary and decision-making and the committee meetings organization and management. The electronic survey was distributed to 50 drug information centers at MOH hospitals. It analyzed the formulary management system at MOH hospitals in Saudi Arabia through Survey Monkey system. Results: A total of 50 drug information centers responded to our questionnaire. The statement with highest score was related to the committee formulary system of medications usage through ensuring the safety of prescribing, distribution, administration and monitoring of medications (3.8); the process for managing drug product shortages (3.76); and the medications are requested for the addition or deletion from the drug formulary (3.68). Most of the hospitals had an open drug formulary (30 (60%)), with remaining responders having closed drug formulary (20 (40%)) with the total number of medications in the drug formulary (300–899) at 32 (64%) of the responded hospitals. The average score of type of method related to drug usage evaluation statements was 3.36, with the statement with high average score was review of medication error report (3.94) and review of medication sentinel incident reports (3.48), whereas the statement with lowest score was an investigational drug therapy approved (2.88). Conclusion: Two-thirds of the hospitals had open drug formulary. Drug utilization evaluation system should review for the majority of the hospital. update the formulary management system required with close monitoring for all MOH hospitals in Saudi Arabia.
ABSTRACT
Objectives: The Pharmacy and Therapeutics (PTC) committee, sometimes aptly named the Formulary Committee. PTC is charged with determining the hospital formulary, decisions are made about the inclusion or exclusion of new pharmacotherapeutic and diagnostic agents for inpatients and outpatients. This committee is typically composed of a multidisciplinary team of pharmacy, physician, nursing and hospital clinical and administrative leadership. The aim of the study was to explore the Therapeutic Committee at MOH hospitals in Saudi Arabia: scope, structure and responsibilities. Methods: It is a 4-month cross-sectional survey of National Survey of Pharmacy and Therapeutic Committee at MOH hospitals in Saudi Arabia. The survey consisted of 93 questions divided in two parts: the first part collects the demographic information, the second part contains questions on 4 domains: (1) scope, structure and responsibilities, that is including questions about the pharmacy and therapeutic committee membership, clear mission, vision and values of the pharmacy and therapeutic committee, the responsibilities of the PTC committee and the Sub-committees of Pharmacy and Therapeutic Committee, (2) formulary management system, (3) evaluation of drug formulary and decision-making, (4) committee meetings organization and management. The survey was distributed to the fifty-drug information centers at Ministry of Health hospitals. The survey was in an electronic format with analyzed scope, structure and responsibilities through the survey monkey system. Results: The total number responders were fifty drug information centers. Of those, 48 (96%) was Saudi and 2 (4%) was non-Saudi. There were 16 (32%) females and 34 (68%) were males. Most of the PTC committee members consisted of a chief of pharmacy department 45 (90%), medical director 41 (82%), physician medical 40 (80%) and head of drug information center 32 (64%). The highest score statements related to committee were the functions of PTC (3.78), objectives (3.61), mission (3.57), with least one was a vision (3.56) and values (3.5). The most responsibility scoring statement was distributed the addition and deletion (4.08), all the departments receive the copy of the revised formulary (4.04), drug evaluation and selection for the hospital was (3.9), drug policy development was (3.9), while the lowest scores were Holds educational programs within the hospital (3.25) and drug monitoring system was (3.57). Most of the subcommittee existed antibiotic committee 38 (76%), medication safety committee 38 (76%), followed by drug utilization committee 9 (18%) and therapeutic guidelines committee 9 (18%). Conclusion: One-third of hospital missed drug information center pharmacist as the member of PTC committee and the pharmacy qualifications of committee members need to improve. Update the committee system and close monitoring required for all MOH hospitals in Saudi Arabia.
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Objectives: To explore the pharmacokinetic services at the Ministry of Health (MOH) hospitals in Saudi Arabia with an emphasis on perceptions and barriers of service implementation. Methods: This is a 2-month cross-sectional national survey of pharmacokinetic services with a focus on pharmacy management and resources at MOH hospitals in Saudi Arabia. The study consisted of two parts: the first part collected demographic information and the second part consisted of 43 questions divided into three domains. The questions were derived from the American Society of Health-System Pharmacists (ASHP) guidelines and from the literature. We used 5-point Likert response scale system with close-ended questions to obtain responses. An electronic questionnaire was distributed to the coordinators of the clinical pharmacy services or drug information centers at MOH hospitals and it analyzed the perceptions and barriers of pharmacokinetic service implementations section through the Survey Monkey system. Results: A total of 43 hospital pharmacies responded to the questionnaire, with the response rate of 86%. The majority of pharmacokinetic services were provided to the adult patients (37 (86.05%)) followed by the pediatric and geriatric patients (19 (44.19%) and 13 (30.23%), respectively) with most of the responding hospitals having less than 20 beds (23 (53.5%)). The categories with most of the barriers of pharmacokinetic service implementation were lack of knowledge (20 (64.52%)), lack of pharmacokinetic education (16 (51.61%)) and lack of an expert pharmacist in pharmacokinetic services (16 (51.61%)). Most of the responders agreed that clinical pharmacokinetic services were necessary for hospitals (23 (53.5%)). The responders agreed that the clinical pharmacist through pharmacokinetic services had a positive financial impact and cost avoidance on healthcare system (23 (53.5%)). Most of the responders stated that pharmacokinetic services improve the safety and efficacy of patient care (33 (89.2%)). Most of the responders agreed that the pharmacokinetic services improved patients’ clinical outcome (33 (89.2%)) and prevented drug-related problems (33 (89.2%)), whereas few of the pharmacokinetic services were provided only 10 (29.4%) over 24 hr per day. Conclusion: Despite the positive attitude of hospital management toward pharmacokinetic services, there was a lack of education and training regarding the same at MOH hospitals in Saudi Arabia. Revision of strategic planning of pharmacokinetic services with regard to their improvement and implementation are required at all MOH hospitals in Saudi Arabia.
ABSTRACT
Objectives: A clinical pharmacist offers vital support in the expansion of a final prescription with improved patient management and enhanced safety. The aim of the current study to explore the Pharmacokinetics services at Ministry of Health (MOH) hospitals in Saudi Arabia with an emphasis on drug therapy monitoring and patient’s education. Methods: This is a 2-months cross-sectional national survey related to the Pharmacokinetics services with a focus on drug therapy monitoring and education of pharmacist at MOH hospitals in Saudi Arabia. The study consisted of two parts; the first part captures demographic information and the second part contained 43 questions designed by the authors. It was derived from American Society of Health-System Pharmacists (ASHP) guidelines and from the literature. We used the 5-point Likert response scale system to obtain responses of the participants; there were close-ended questions. The electronic questionnaire was distributed to all the coordinators of the clinical pharmacy services or to the drug information centers at MOH hospitals. All analysis was done through survey monkey system. Results: A total of 43 hospital pharmacies returned the survey, for a response rate of 86%. The most clinical pharmacokinetics services documented were drug quality reporting 34 (87.18%), drug information inquiries 35 (83.33%), adverse drug reaction 35 (81.40%) and medication error 35 (81.40%). Highest clinical impact and cost avoidance of clinical Pharmacokinetics services were drug information inquiries 25 (60.98%), the drug quality reporting system 21 (53.85%) and pharmacist intervention 21 (52.5%). Analysis of monthly workload for clinical Pharmacokinetics services were a number of drug information inquiries 28 (70%) and the number of prescriptions needs 25 (64.1%). The clinical Pharmacokinetics services education and training for pharmacists were found at average 7.8 (20.89%) hospitals with high percentages type of educations was short education course 1-5 days [15 (39.47%)] and long training course 4-5 weeks [8 (21.05%)]. While Pharmacokinetics services education and training for healthcare provider were found at main 6 (15.66%) hospitals only with high percentages type of educations was short education course 1-5 days [8 (20.00%)] and Pharmacokinetics competencies 7 (18.92%). Conclusion: Pharmacokinetics services on drug therapy monitoring was not competent at half MOH hospital, while only few of the hospitals had pharmacokinetics education and training to offer. Implementing the MOH pharmacokinetics services strategy with an emphasis on the drug therapy monitoring with education and training is required at all MOH hospitals in Saudi Arabia.
ABSTRACT
Objectives: To explore the pharmacokinetics services at the Ministry of Health (MOH) hospitals in Saudi Arabia with an emphasis on prescribing and dispensing medication. Methods: This is a 2-month crosssectional national survey of pharmacokinetics services. The study consisted of two parts: the first part captures demographic information and the second part is a questionnaire with 43 questions divided into three domains. The questions are derived from the guidelines of the American Society of Health- System Pharmacists (ASHP) and from the literature. We used the 5-point Likert response scale system to obtain responses of the participants; there were close-ended questions. The electronic questionnaire was distributed to all the coordinators of the clinical pharmacy services or to the drug information centers at MOH hospitals, The data were collected through the Survey Monkey system. Results: A total of 43 hospital pharmacies responded to the survey; the response rate was found to be 86%. The pharmacists and nurses had privileges of prescribing medication as per pharmacokinetics services in nearly 18 (46.15%) and 16 (41.03%) hospitals respectively. At 14 (37.84%) hospitals, pharmacists have the privilege to request an estimation of patient’s drug levels and at 12 (30.77%) hospitals, they have the privilege to change drug sampling time. At 15 (38.46%) hospitals, nurses have the privilege to request an estimation of patient’s drug level and at 12 (31.58%) hospitals, they have the privilege to change drug sampling time. The commonly prescribed medications via pharmacokinetics consultation were gentamicin (23 (71.88%)), phenytoin (23 (71.88%)), carbamazepine (22 (70.97%)), sodium valproate (22 (70.97%)) and warfarin (22 (70.97%)). The pharmacokinetics altering system during an electronic prescription was found in 9 (26.5%) hospital pharmacies and the pharmacist was found to participate in pharmacokinetics research in 8 (23.5%) hospitals. Conclusion: Healthcare providers including the pharmacists and nurses have a significant role in providing pharmacokinetics services to the patients. Expanding these services with standard guidelines and the electronic prescription is required in order to prevent drug- Pharmacokinetics related problems, improve the clinical outcome of the patient and reduce the economic burden.