E-drug: Re:Drug and Therapeutics Committees (2)
----------------------------------------------------------
Dear Dr Edelisa Carandang,
In reply to your query about Hospital Therapeutic committees, it became
essential in our practices to form a therapeutic committee of the three
regional and all the district hospitals of the region.
The need arose from evidence of the multi-resistant growth patterns of
organisms within the hospital I work in as well as the overall prescribing
patterns which were far from being cost effective. The other hospitals
probably had the same experiences which they were not quite aware of as
their infection control committees were not functioning as effectively in
the collating of data.
After much consultation, in March 1997, it was decided with management that
the formatiom of a therapeutic committee was necessary.
Getting all around the table from the three regional hospitals was the major
problem. The hospital managers, directors, all consultants from the various
disciplines, senior nursing personnel able to disseminate the relevant
information and pharmacists were invited to the formation of a therapeutics
committee. The greatest fear from some of the consultants was that the
doctors prescribing rights would be infringed upon. Others saw a clear need
for guidelines and protocols because of the wide variations in training.
As it was my brainchild, I was asked at first to be secretary so as to
furnish material to stimulate discussion, to invite specialists from the
medical university and teaching hospital to present data on topics which
would enable our committee to formulate guidelines. Presently, I have to do
both the secretarial and chairman functions.
Initially, the use of antibiotics was addressed. An invited consultant from
the Medical school spoke to the committee pointing out the importance of
adhering to protocols. He stressed that with antibiotics it had to be
"protocols" and not "guidelines" if there was to be any success in curbing
resistant patterns and to be able to continue being able to treat
effectively. The protocol after being drawn up was ratified by the committee
before being detailed and accepted by the doctors, pharmacists and nurses in
their own settings.
Progress has been made in developing Hypertension, Diabetes,
Helicobacter Pylori, Asthma and NSAID protocols. Initially it was believed
that these would be guidelines. With fastly dwindling resources, the
guidelines had to be used as protocols in the entire region.
To enable all to share the practice of sound therapeutic practices, each
hospital has a plan of implementation. At Grey's Hospital, the protocols are
detailed to all doctors, nurses and pharmacists before they are put into
practice at a meeting.
It is a delight to tell you that much respect has been gained by the
different professions in working together to deliver cost effective
therapeutics.
The actual sharing of successes and problems has enabled the three major
institutions to strive for a standard of good practice.
The committee is called: The Joint Therapeutic Committee of Pietermaritzburg
(Grey's, Edendale and Northdale Hospitals)
Address: c/o (Ms) Mariam Cassimjee, address as below
A problem in implementing the irradication of Helicobacter Pylori was that
our suppliers ran out of stock of Liquid Bismuth Compound for many months
and the more expensive protocol then had to be followed.
I will endeavour to send you copies of existing guidelines ASAP.
Thank you for allowing me to share this with you.
(Ms) Mariam Cassimjee,
Dept of Pharmacy,
Grey's Hospital,
P/Bag X9001,
Pietermaritzburg 3201,
South Africa.
Tel: (331) 458181 ext 2124 (Work)
(331) 945824 (Home)
e-mail: mimi-cass@mail.tcs.co.za
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.