E-drug: Re: D&T committees (contd)
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Assuming that D&T committees use amongst others, the evidence-based medicine
approach when deciding on protocols or drug regimens, one can argue that a
similar approach may be suitable for determining outcomes. Richard Laing
gave some useful examples of outcome measures. If these outcomes are
carefully monitored and documented a body of evidence can be built that can
eventually be compared to the original clinical trials, etc. that were used
in the decision process. This process would have some similarities to
post-marketing surveillance of drugs, but the goals are different, i.e.
measuring the success of D&T committees to enhance rational drug use.
Another advantage of determining outcomes (not possible by measuring
outputs) is that adverse drug reactions can be effectively monitored. An
intervention by a D&T committee may initially seem rational in light of
evidence, but may ultimately be irrational in the presence of increased
mortality and morbidity due to adverse drug reactions. Agreed, much work
need yet to be done.
Samuel Wagner Ph.D.
Specialist in Pharmaceutical Economics
PRIME Institute
Room 7-194
College of Pharmacy Tel. 612 625 4186
Weaver-Densford Hall Fax 612 625 9931
University of Minnesota
308 Harvard Str. S.E.
Minneapolis 55455, MN
USA
email: wagne051@gold.tc.umn.edu
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