Chapter 4

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CHAPTER 4

Pharmacy and
Therapeutic Committee
Saima Asghar
Saima.asghar@iub.edu.pk
Contents
• Introduction
• Objective of P&TC
• Composition of P&TC
• Operations of P&TC
• Roles and responsibility of P&TC
Introduction
• The Pharmacy and Therapeutic Committee is a policy forming and
advisory group to the medical staff and administration of hospital on
matters related to therapeutic use of drugs. It is actually a policy-
recommending body to medical staff and the administration.
• The committee is composed of physicians, pharmacists and other
healthcare professionals.
Objectives of P&TC
P&TC has 3 major roles to play:
1. Advisory
2. Educational
3. Drug safety and adverse drug monitoring
1. Advisory
• The committee recommends the adoption of policies or assists in the
formulation of broad professional policies regarding evaluation,
selection and therapeutic use of drugs in the hospital.
• The committee serves in an advisory capacity to medical staff and
hospital administration in all matters pertaining to the use of drugs,
including the investigational drugs.
• It makes recommendations concerning the drugs to be stocked in
hospital patient care areas.
• The committee advises the pharmacy in implementation of effective
drug distribution and control procedures.
2. Educational
• The committee recommends or assists in the formulation of functions
designed to meet the needs of professional staff, for the complete
current knowledge of the matters related to the drugs and their use.
• The committee evaluates the problems related to the distribution and
administration of medicines, including medication incidents.
• The committee develops and compiles a formulary of drugs and
prescriptions of formulations accepted for use in the hospital.
• The committee should minimize the duplication of the same basic
drugs, drug safety and cost concerns with this duplication.
• It establishes or plans suitable educational schemes for the hospital’s
professional staff on the matters related to the use of drugs.
3. Drug safety and adverse drug monitoring

• The function is assigned to or taken up by the P&TC and it should be


continuous scheme of exerting vigilance.
Composition of P&TC
It may vary from hospital to hospital and generally comprised of:
• At least 3 physicians from the medical staff
• 1 pharmacist
• 1 representative of the nursing staff
• 1 representative of administration
• All of the committee members are either appointed by a hospital
governing unit or elected officially from the medical staff.
• A senior member from medical staff is appointed as Chairman of
committee.
• Senior pharmacist or director of pharmacy is appointed as Secretary
of the P&TC.
• Being secretary Pharmacist is responsible for developing agenda and
preparation and distribution of minutes of meeting.
• A subcommittee on some specialized interest or subject can be
established on temporary or permanent basis, e.g., a committee on
Hospital Formulary development and implementation, antiinfective
etc.
Operations of P&TC
• The committee should meet at least six times per year, and more often
as necessary.
• The committee can invite within or outside of the hospital, a specialist
who can contribute specialized skill and judgment on any particular
matter. e.g., dengue fever or immunization.
• An agenda and supplementary materials including minutes and
proceedings of previous meetings should be prepared by the secretary
and furnished to the committee members in advance so that the
members can study them properly before the meeting.
• Decisions and actions of the committee should be routinely
communicated to the concerned hospital administration and staff and
other government authorities as deemed appropriate by the committee.
• A typical agenda may consists of the following categories in general:
• Minutes of the previous meeting
• Review of the contents of the hospital formulary for the purpose of
brining it up-to-date, and deleting of products not considered
necessary for use.
• Information regarding new drugs.
• Review of side effects, ADRs, toxicity and drug interactions reported
by various units of the hospital and brought to the notice of
committee by DIC.
• Review of drug safety.
• Reports of various sub committees.
• Reports of medical audit.
• Any other matter with the permission of chair.
• Vote of thanks.
The minutes of all meetings held should be prepared by the secretary
and a permanent record of these minutes should be maintained in the
hospital.
Responsibility of P&TC
• Ensure safety medications to the patients
• Preparation of hospital formulary
• Publishing of a pharmacy educational bulletin
• Establishment of automatic stop orders for dangerous drugs
• The supervision of investigational use of drugs
• The development of a program for investigating and reporting adverse
drug reactions of drugs
• Assisting in the preparation of emergency kits or carts for medical
emergencies
Policies regarding the control of drug
utilization
• Policies concerning Formulary

• Policies concerning Drug Recall

• Policies regarding In-patient Prescription Orders

• Policies related to Out-patient Prescription Orders


Policies concerning Drug Formulary
• Proposal of new drug for inclusion into drug formulary
• Drug evaluation for inclusion into formulary
• Conditionally-approved drug for a Trial period
• Specialized Formulary drug
• Investigational use of new drug in a Clinical Trial
• Non-Formulary drugs with special requirements and limited stock
• Generic versus Brand Name prescription and Generic Drug
substitution
Policies concerning Recall
• Drug Recalls may be issued from Manufacturer, Drug Authorities or
Pharmacy Department due to faulty manufacturing
• Any Adverse Reaction to a drug
• Changes in Indication or labeling requirements
• Wrong manufacturing or reconstitution technique
• Near expiry or expired drug dispensing
• Unexpected adverse drug reaction to certain batch of drug
• Proper Identification and retrieval of drug batches should be carried
out with proper documentation as to the reason, quantity and scope
of recall
Policies regarding In-patient Prescription order
• Routine Drug Orders
• Intravenous Mixture Orders
• Total Parenteral Nutrition
• Self-medication
• Prescribing Controlled Drugs
• Discharge Medication
• Emergency Medications
Policies regarding out-patient Prescription order
• A Prescription for any drug or medical supply that is to be dispensed
to out patients, clinic patients, employees and patients at discharge.
• Policies regarding any reimbursement to out patients.

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