AGA KHAN UNIVERSITY HOSPITAL PROMOTES RATIONAL MEDICINES USE THROUGH PHARMACY AND THERAPEUTICS COMMITTEE Sital Shah B

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Presentation Outline. Aga Khan University Hospital, Nairobi (AKUH-N) Pharmacy
AGA KHAN UNIVERSITY HOSPITAL PROMOTES RATIONAL MEDICINES USE...

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1. AGA KHAN UNIVERSITY HOSPITAL PROMOTES RATIONAL MEDICINES USE THROUGH PHARMACY AND THERAPEUTICS COMMITTEE Sital Shah BSc, M.PharmS Opportunities & Challenges in Hospital Pharmacy Practice in Kenya The Panafric Hotel, Nairobi, March 24, 2007

2. Presentation Outline Aga Khan University Hospital, Nairobi (AKUH-N) Pharmacy & Therapeutics Committee (PTC) Effective implementation of responsibilities Recent accomplishments of PTC Promotion of rational use of drugs Evidence and experience of using WHO-INRUD prescribing indicators Successful formulary management Performing DUE?s Lessons Learned

3. AKUH(N) Human Resources and Number of Patients Served

4. Mission Statement of AKUH(N) - Pharmacy Services At The Aga Khan Hospital, pharmacists improve medicine use by working with the multidisciplinary ward team, including the patient, and providing advice and information that promotes safe, rational and economic medicine use PTC effectively works towards this mission statement

5. Strengths of the AKUH(N)-PTC Established in 1998 PTC works towards hospital?s mission Wide representation (12 members from multiple disciplines) Clear terms of reference Frequent PTC meetings (12 in 2005 &15 in 2006) Good attendance in meetings (average - 80%) All PTC meetings documented through minutes and are archived

6. Strengths of the AKUH(N)-PTC PTC staff are well trained Chief Pharmacist (PTC secretary) trained in International Drug & Therapeutics Committee-Training of Trainers course in Nov-Dec 2005, in Malaysia Organized by University of Science Malaysia and RPM Plus program of Management Sciences for Health in collaboration with WHO Member of recently established ?Antibiotics Consensus Group of Kenya?

7. Responsibilities of AKUH(N)-PTC Advise other departments on drug use issues Develop drug policies and procedures Evaluate and select drugs for the formulary Assess drug use to identify potential problems Promote effective interventions to improve drug use (including educational, managerial, and regulatory methods) Manage adverse drug reactions Manage medication errors

8. Accomplishments of AKUH(N)-PTC Selected effective, safe, high quality, cost-effective drugs for the formulary- [a formal process is in place] Improved drug procurement and inventory management Management of drug costs- [ABC analysis] Improved the use of drugs by intervention studies [e.g. prescribing indicators - coupled with feedback & education to improve quality of patient care & treatment outcomes]

9. Accomplishments of AKUH(N)-PTC Increased staff and patient knowledge- [newsletters and in-service education] Managed antimicrobial resistance- [established an antimicrobial sub-committee, working on antibiotic guidelines, performed DUE?s] Decreased adverse drug reactions (ADRs) and medication errors- [monitored though reporting]

10. Successful Formulary Management Training Experience Sharing by PTC Two day training was organized on formulary management for AKUH staff from Mombasa, Kisumu and Dar es Salaam in November 2006 3 pharmacists, 6 doctors and 3 CEO?s Best practices in managing the drug formulary discussed through case studies, examples and cost-effective measures Each hospital was asked to provide action plan

11. Promoting Rational Use of Medicines Experience of PTC Setting: AKUH(N) Outpatient (PHC) Department Average of 1400 drugs dispensed each day Average of 400 patients seen each day The Problem High incidence of injection use observed Irrational use in some cases Evidence in numbers was lacking

12. Methods ? What was the Intervention? PTC approved conducting drug use study at outpatient department WHO-INRUD prescribing indicators were applied and data was shared in PTC meeting involving the head of outpatient department The PTC decided to remove three injections and provide education on rational use for six other injections Five months later, prescribing indicators were applied again (May 2006)


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