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Int J Pharmacol. Clin. Sci Research Article
National Survey of Pharmacy and Therapeutic Committee in
Saudi Arabia: Meetings, Organization, and Management
Yousef Ahmed Alomi* , The Former
General Manager of General Administration ABSTRACT
of Pharmaceutical Care, The Former Head, Objective: Pharmacy and Therapeutic Committee (PTC) is required for the effective
National Clinical Pharmacy and Pharmacy running of a hospital. In the beginning, there was no such concept of drug committee,
Practice, The Former Head, Pharmacy R & D but with the advent of time, the need for an effective PTC started increasing. In the
Administration, Ministry of Health, Riyadh,
SAUDI ARABIA. PTC, the pharmacist, physicians and nurses play an important role, in addition to the
Sultan Mohammed Al-Jarallah, Head, presence of an administrative. This study aims to explore the importance of having
Ambulatory Care Pharmacy, Oncology and effective meetings organization and management of PTC at Ministry of Health (MOH)
Hematology Clinical Pharmacist, Pharmaceutical hospitals in Saudi Arabia. The purpose of this study was to explore the meetings
Care Department, Security Forces Hospital, organization and management of PTC at MOH hospitals in Saudi Arabia. Methods:
Riyadh, SAUDI ARABIA. This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia.
Rasha Abdelsalam Elshenawy,BCS. Pharm. The survey consisted of two parts: the first part collected demographic information
BCPS (AQ-ID), CPHQ, M.Sc., TQM (AUC), SIDP, and the second part consisted of 93 questions divided into four domains: Domain 1:
CEO of FADIC, Ministry of Health, Makkah,
SAUDI ARABIA. the scope, structure and responsibilities; domain 2: the formulary management
Faiz A Bahadig Rph, Informatics Pharmacist, system; domain 3: evaluation of drug formulary and decision-making; and domain 4:
Pharmaceutical Care Department, organization and management of committee meetings. This questionnaire was
King Abdulaziz Medical City-WR-Jeddah, prepared in an electronic format and was distributed all drug information centers at
Ministry of National Guard, SAUDI ARABIA. MOH hospitals. It analyzed organization and management of committee meetings
Correspondence: through Survey Monkey system. Results: A total of 50 drug information centers
Dr. Yousef Ahmed Alomi, The Former responded to the questionnaire (100% response rate). The person leads the discussion
General Manager of General Administration in PTC was a Chairman of the Committee (29 (58%)), Chief of Pharmacy (13 (26%))
of Pharmaceutical Care, The Former Head, and Director of Drug Information (3 (6%)). The number of scheduled meetings per
National Clinical pharmacy and pharmacy year (1–4) was 18 (36%) per hospital with a duration (1-2 hrs) at 48 (96%). Most of
practice, The Former Head, Pharmacy discussions were related to medications of infectious diseases (26 (52%)) and
R & D Administration, Ministry of Health, cardiovascular diseases (21 (42%)). Most of the challenging recommendations that
Riyadh, SAUDI ARABIA. needed implementation was a lack of resources (37 (74%)), lack of hospital administrator
Phone no: +966504417712 support (23 (46%)) and lack of pharmacist role (18 (36%)). Conclusion: The PTC is a
E-mail: yalomi@gmail.com 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.
Keywords: National Pharmacy and Therapeutic Committee, Ministry of Health,
Saudi Arabia, Meetings, Organization and Management.
INTRODUCTION
PTC is demandable running of a hospital effec- meetings were reported to be official gatherings
Received: 03-05-2019; tively. In the beginning, there was not any concept with a prepared agenda (supplemented in many
Accepted: 27-06-2019 drug committee, but with the progress of time, hospitals with review materials). Almost all
the need for starting an active PTC is increas- respondents reported that committee minutes
Copyright: © the author(s), publisher and licensee ing. In the PTC Committee, the pharmacist, were generated immediately after the meeting,
International Journal of Pharmacology and Clinical physicians and nurses play an essential role, in with most hospitals requiring the approval of
Sciences. This is an open-access article distributed addition to the presence of an administrative.[1,2] the minutes by the committee before they were
under the terms of the Creative Commons Attri- For running a better PTC, not only the expen- issued. PTC met regularly, with an average of 9.7
bution Non-Commercial License, which permits ditures, but also the actively participating mem- meetings per year. The meetings averaged more
unrestricted non-commercial use, distribution, and
[2]
reproduction in any medium, provided the original bers, frequently organized the meeting and clear than an hour. The study of the characteristics of
work is properly cited. agenda is also a must. In the study of Improving pharmacy and therapeutics committees in Saudi
This is an open access article distributed under the the performance of Drug and therapeutics com- hospitals shows that adopting PTC in Saudi
terms of the Creative Commons Attribution-Non- mittee (DTC) in hospitals–a quasi-experimental governmental hospitals is a common practice
Commercial-ShareAlike 4.0 License Only 9 (45%) of the committees distribute the
study in Laos concluded that continuous self-
monitoring of performance using indicators and agenda of meeting to their members 6 days or
Access this article online feedback discussions, is the means of improving more before the meeting date. The average number
[3] of meetings is 12 meeting per year. The average
WWW.ijpcs.net the performances of the DTC. In 1999, the
study of the Activities, functions and structure of number of drugs deleted or added to the formulary
[4]
pharmacy and therapeutics committees in large is 6.3 and 19.2 drugs per year. As every hospital
DOI: teaching hospitals, concluded that the Committee should establish a multidisciplinary pharmacy
10.5530/ijpcs.2019.8.52 meetings and policies and procedures. PTC in the and therapeutics committee or equivalent to
responding hospitals functioned formally. The provide oversight of the hospital formulary and
International Journal of Pharmacology and Clinical Sciences, Vol 8, Issue 4, Oct-Dec, 2019 237
Alomi, et al.: Pharmacy and Therapeutic Committee in Saudi Arabia: Meetings, Organization and Management
[5,6]
medication use. Unfortunately, not all the Table 1: Demographic information regarding responder’s qualifications.
PTC is working efficiently. This study aims to Gender Response Count Response Percent
explore the organization and management of
the meeting of the Pharmacy and Therapeutics Male 34 68.0%
Committee at the MOH hospitals in KSA. Female 16 32%
METHODS Answered question 50
This is a 4-month cross-sectional national survey Skipped question 0
of PTC at MOH hospitals in Saudi Arabia. The Nationality Response Count Response Percent
survey consisted of two parts: the first part Saudi 48 96.0%
collected demographic information and the Non- Saudi 2 4.0%
second part consisted of 93 questions divided Answered question 50
into four domains: domain 1: scope, structure
and responsibilities; domain 2: formulary Skipped question 0
management system; domain 3: evaluation Academic Qualification (s): Response Count Response Percent
of drug formulary and decision-making; and Diploma. Pharmacy 2 4.00%
domain 4: organization and management of Bsc. Pharmacy 23 46.00%
committee meetings, which includes leading
meeting discussion of PTC, the responsibility Master of Science 10 20.00%
of preparing meeting agenda of PTC, the Master Clinical Pharmacy 9 18.00%
responsibility for monitoring activities or Doctor of Pharmacy 10 20.00%
assignments, number of PTC scheduled meeting
annually, number of PTC held meeting Two years Residency (R1) 0 0.00%
annually, duration of PTC meeting (hours), Three years Residency (R2) 0 0.00%
number and class of medications evaluated by Ph. D 2 4.00%
the PTC monthly, assessment of PTC meetings M.B.A. 1 2.00%
and the barriers of PTC policy implementations.
This survey was derived from previous literature, Other (please specify) 1 2.00%
local regulation and ASHP standards of PTC Answered question 50
and formulary system.[1,2,5-8] The 5-point Likert
response scale system was used with close-ended Skipped question 0
questions. The survey was distributed to 50 drug Total years you worked as pharmacist Response Count Response Percent
information centers at the MOH hospitals. > 1 year 1 2.0%
Hospitals of all sizes/capacity or any type of 1 – 3 years. 4 8.0%
specialty were included in the study. The survey 4-6 years. 10 20.0%
was prepared in an electronic format and it
analyzed the organization and management of > 6 years. 35 70.0%
committee meetings through Survey Monkey Answered question 50
system. Skipped question 0
RESULTS Position in P&T committee Response Count Response Percent
A total of 50 drug information centers Chairman 4 8.3%
responded to the questionnaire. Of them, 48 Vice-chairman 15 31.3%
(96%) were Saudi and 2 (4%) were non-Saudi Secretary 6 12.5%
centers. There were 16 (32%) female and 34 Coordinator 2 4.2%
(68%) male responders. Most of the responders
had Bachelor Degree in Pharmacy (23 (46%)), Assistant secretary 2 4.2%
followed by Diploma in Pharmacy (10 (20%)) Committee member 21 43.8%
and Master of Clinical Pharmacy (9 (18%)) Answered question 48
with an experience of more than 3 years as the Skipped question 2
pharmacist (45 (90%)). The majority of the
responders were PTC members (21 (43.8%)) Years of Experiences as a P&T committee Response Count Response Percent
and vice-chairman (15 (31.3%)) with a duration member
of 1–6 years (64%) in PTC membership (Table 1). > 1 year 10 20.0%
The majority of the responders were from 1 – 3 years. 17 34.0%
hospitals with 100–299 beds (28 (56%)) with
accreditation obtained from CBAHI (33 (66%)), 4-6 years. 15 30.0%
Saudi Commission of Health Specialties > 6 years. 8 16.0%
(15 (30%)) and Joint Commission USA (13 (26%)) Answered question 50
(Table 2). Chairman of the committee leads the Skipped question 0
discussion in the PTC (29 (58%)), followed by
238 International Journal of Pharmacology and Clinical Sciences, Vol 8, Issue 4, Oct-Dec, 2019
Alomi, et al.: Pharmacy and Therapeutic Committee in Saudi Arabia: Meetings, Organization and Management
Table 2: Demographic information of hospital. Table 4: Number of PTC scheduled meeting
Number of beds at your hospital Response Count Response Percent annually.
< 50 4 8.0% Answer Response Response
50-99 6 12.0% Options Count Percent
100-199 14 28.0% 1-4 18 36.0%
200-299 14 28.0% 5-8 16 32.0%
300-399 5 10.0% 9-12 15 30.0%
400-499 4 8.0% > 12 1 2.0%
500-599 2 4.0% answered question 50
= or > 600 0 0.0% skipped question 0
Medical City 1 2.0% Number of PTC held meeting annually
Answered question 50 Answer Response Response
Skipped question 0 Options Count Percent
The hospital accreditation Response Count Response Percent 1-4 31 62.0%
CBAHI 33 66.0% 5-8 7 14.0%
Joint Commotion USA 13 26.0% 9-12 12 24.0%
Canada 0 0.0% > 12 0 0.0%
Saudi commission of health specialties 15 30.0% answered question 50
Non accredited 11 22.00% skipped question 0
Answered question 50
Skipped question 0 Duration of PTC meeting (hours)
Answer Response Response
Table 3: Leading discussion during meeting by PTC. Options Count Percent
Answer Options Response Count Response Percent 1 28 56.0%
Chairman committee 29 58.0% 2 20 40.0%
Chief of Pharmacy 13 26.0% 3 1 2.0%
Chief Drug information Center 3 6.0% > 3 1 2.0%
Drug information (DI) pharmacist 2 4.0% answered question 50
Secretary 2 4.0% skipped question 0
Shared leadership 0 0.0%
Medical director 1 2.0%
answered question 50 Chief of Pharmacy (13 (26%)) and Director of
skipped question 0 Drug Information 3 (6%). Head of the phar-
The responsibility of preparing meeting agenda of PTC macy prepares the meeting agenda (22 (44%)),
Answer Options Response Count Response Percent followed by Secretary (15 (30%)) and Chief of
Secretary 15 30.0% the Drug Information Center (4 (8%)). Head of
Chief of Pharmacy 22 44.0% the Pharmacy is responsible for the monitoring
Chief of drug information center 4 8.0% activities (20 (40%)), followed by Chairman of
Drug Information Pharmacist 3 the Committee (11 (22%)) (Table 3). The number
6.0% of scheduled meetings per a year 1-4 was 18
Chair of committee 4 8.0% (36%) with a duration of 1-2 hrs (48 (96%)).
Coordinator of P& T committee 2 4.0% Medication for infectious diseases were the
answered question 50 majority class sold (26 (52%)), followed by
skipped question 0 cardiovascular medication (21 (42%)) (Tables 4
The responsibility for monitoring activities or assignments and 5). The statement with scores on prepa-
ration of agenda from before the meeting to
Answer Options Response Count Response Percent the final distribution was 4.28–4.62. The most
Secretary 11 22.0% challenges of PTC recommendation imple-
Chief of Pharmacy 20 40.0% mentation was a lack of resources (37 (74%)),
Chief of drug information center 6 12.0% lack of hospital administrator support (23 (46%))
Drug Information Pharmacist 2 4.0% and lack of pharmacist role (18 (36%)) (Tables 6
Chair of committee 11 22.0% and 7).
Other 0 0.0% DISCUSSION
answered question 50 The first PTC was established almost more
skipped question 0 than 30 years ago and most of the PTCs at
International Journal of Pharmacology and Clinical Sciences, Vol 8, Issue 4, Oct-Dec, 2019 239
Alomi, et al.: Pharmacy and Therapeutic Committee in Saudi Arabia: Meetings, Organization and Management
Table 5: Number of medications evaluated by the PTC monthly. Table 7: The barriers of PTC policy implemen-
Answer Options Response Count Response Percent tations.
< 1 7 14.00% Answer Options Response Response
1 19 38.00% Count Percent
2 12 24.00% Lack of resources 37 74.0%
3 11 22.00% Lack of hospital
4 5 10.00% administration 23 46.0%
support
5 3 6.00% Lack of Pharmacy
6 0 0.00% staff 14 28.0%
7 0 0.00% Low Pharmacy
8 0 0.00% and Therapeutic 13 26.0%
9 0 0.00% Committee profile
10 1 2.00% Lack of pharmacist 18 36.0%
answered question 50 role
skipped question 0 Conflict with 10 20.0%
In the past 12 months, The type of medications discussed at Pharmacy and Therapeutic Committee meet- pharmacy policy
ing Lack of cooperation
between PTC
Answer Options Response Count Response Percent committee and 1 2.0%
Gastro-intestinal system 15 30.00% always fill the agenda
Cardiovascular system 21 42.00% by discussion title for
Respiratory system 13 26.00% SBAHI only
Central nervous system 22 44.00% answered question 50
Infections 27 54.00% skipped question 0
Endocrine system 7 14.00%
Obstetrics disorders 5 10.00% MOH hospitals were founded during the
Gynecology disorder 11 22.00% previous pharmacy strategic plan (2002–2010).
Urinary-tract disorder 11 22.00% There were goals and objectives and policies
Malignant disease 3 6.00% and precedencies of addition and deletion of
immunosuppressant 10 20.00% medication from MOH drug formulary. The
Nutrition and blood 0 0.00% corporate PTC was updated during the period
of 2010-2015. For any hospital to work effec-
Musculoskeletal and joint diseases 5 10.00% tively, the PTC is a must. Although previously,
Eye disorder 11 22.00% this concept did not exist in hospitals, with the
Ear, Nose and Or pharynx 3 6.00% passage of time, there is a tremendous need
Skin disorders 5 10.00% for such PTCs and now it has been compulsory
Immunological products and vaccines 1 2.00% in hospitals throughout the world. The hospitals
Anesthesia 10 20.00% which lack the committee suffer economically.
answered question 50 Because of the presences of such a large number
of drugs, the inventory increases while the
skipped question 0 turnover rate decreases. This happens because
[4]
of the absence of PTC. The national drug
Table 6: Assessment of PTC meetings. information center coordinate with all drug
Answer Options Always Often Sometimes Rarely Never Rating Response information centers during the follow-up of
Average Count regional and peripheral PTC. All PTCs should
Agenda prepared before 37 10 0 3 0 4.62 50 organize meetings annually, prepare the agenda
meetings and lead the discussion during the meeting.
Meeting minutes always 29 10 8 2 1 4.28 50 In this study, our findings showed that the
generated after committee pharmacist mostly prepared the agenda for
meetings discussion followed by the secretary. This may
Review materials attached 26 16 6 2 0 4.32 50 be because the pharmacy had an active role in
[9]
to agenda the PTC and the secretary has a minor job
Meeting minutes receive 27 12 8 0 1 4.33 48 in the committee. While the drug information
final committee approval pharmacist seldom had the involvement in the
before issued preparation of the agenda with unclear reason.
answered question 50 The responsibility of preparing the agenda
skipped question 0 was with secretary and head of the pharmacy,
which was similar to a previous study, whereas
240 International Journal of Pharmacology and Clinical Sciences, Vol 8, Issue 4, Oct-Dec, 2019
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