Improving the performance of Drug and Therapeutics Committees in hospitals--a quasi-experimental study in Laos.
OBJECTIVE
Drug and Therapeutics Committees (DTCs), which are essential for ensuring the rational use of drugs (RUD) in hospitals, have recently been established in Laos. Sub-optimal performance had been reported. The aims of this study were to determine those factors in the working environment that relate to DTC performance in Lao hospitals and evaluate whether DTC performance could be improved through an educational intervention utilizing auditing and feedback targeted towards DTC members.


METHODS
This was a quasi-experimental (before and after) study. Two central and seven provincial hospitals and the DTC members from these hospitals participated in the study. Performance of the DTCs was assessed by means of specifically developed indicators on structure and process combined with indicators for RUD and adherence to Standard Treatment Guidelines (STG). Data were collected for a 3-month period at baseline and for three consecutive periods thereafter. The results of the first three data collections were shared and discussed with the DTC members during feedback sessions. The DTC members were also interviewed in order to identify factors they thought may have an impact on DTC performance.


RESULTS
Following the intervention, there was a significant improvement in the overall score for DTC performance (p<0.001) and, in particular, in general activity and feedback and drug information to staff. The STG scores also improved (p<0.01). Interviews indicated that one negative factor was the experience of the DTC members being overloaded with other work, resulting in DTC meetings being held irregularly and drawing poor attendance.


CONCLUSIONS
Continuous self-monitoring of performance by means of indicators, followed by feedback discussions, is suggested the means of improving the work of the DTC.
Vang
Chu
C
Department of Cardiology, Mahosot Hospital, Vientiane, P.O. Box 5202, Lao People's Democratic Republic (Laos), and Nordic School of Public Health, Goteborg, Sweden. wachuvang@yahoo.com
Tomson
Goran
G
Kounnavong
Sengchan
S
Southammavong
Thanakhanh
T
Phanyanouvong
Amphayvanh
A
Johansson
Rolf
R
Eriksson
Bo
B
Wahlstrom
Rolf
R
D003141:Communicable Diseases / Q000188:drug therapy; D017723:Drug Utilization Review; D019983:Guideline Adherence / Q000592:standards*; D006302:Health Services Research; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D007812:Laos; D010606:Pharmacy and Therapeutics Committee / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000592:standards