Pharmacy and Therapeutics Committee - Objectives, Composition, and Functions

The Pharmacy and Therapeutics Committee (PTC)

The Pharmacy and Therapeutic Committee (PTC) consists of physicians, pharmacists, and some other healthcare professionals. The pharmacy and therapeutics committee is an advisory body to promote the appropriate use of high-quality and cost-effective pharmaceuticals. It recommends policies to medical staff and hospital administration on matters related to the therapeutic uses of drugs. It advises on all matters related to pharmaceuticals used in hospitals including the evaluation of drug and dosage forms, and the safe use of investigational drugs. It plays both advisory and educatory roles.

OBJECTIVES: To provide advice to medical staff and to educate them regarding current developments in medical fields.

• 1. Advisory role: PTC develops policies and procedures regarding the selection, procurement, dispensing, labeling, availability, administration, and control of drugs throughout the hospital.

• 2. Educational role: PTC assists physicians, pharmacists, nurses, and other health care professionals with various functions recommended to them. PTC imparts current knowledge to them related to drugs.

The Pharmacy and Therapeutics Committee (PTC) Functions

PTC performs the following functions

• 1. Advisory: It provides suggestions to medical staff and hospital administration regarding therapeutic uses of drugs.

• 2. Hospital Formulary: PTC develops and compiles the formulary of drugs and prescriptions to be used in the hospital. “Hospital formulary is listing of medication that hospital pharmacy stock along with all information of each medicine”. PTC develops hospital formulary on the basis of their therapeutic use, safety, price, etc. These drugs are approved by PTC for routine patient care.

• 3. Procurement policies: PTC develops procurement policies regarding the selection of drugs, selection of suppliers, quotation/tender invitation, storage conditions, etc

• 4. Distribution: PTC develops policies regarding dispensing medicines to OPD patients and IPD patients.

• 5. Educational: PTC develops training policies regarding the duration of the training, timing of training, and participation in training for hospital staff arranged by hospital administration

• 6. Emergency drugs: PTC recommend a list of drugs as an emergency drug to be stored in each ward of the hospital and its ready availability for patients

• 7. Drug distribution system: Each hospital follows any one drug distribution system. Hospital administration shall implement it after consulting PTC and upon PTC's recommendation

• 8. Pharmacovigilance: PTC plays a vital supervisory role in pharmacovigilance inside the hospital. PTC shall be responsible for the decision and coordination of pharmacovigilance activities in the hospital.

• 9. PTC shall act on behalf of the medical board of the hospital. The decision and action of PTC are subject to the approval of the board. This indicates PTC is a purely advisory body.

Composition of Pharmacy and Therapeutics Committee (PTC)

The Pharmacy and Therapeutics Committee consists of the Chief medical officer, the Administrator,  the Chief hospital pharmacist, and one nursing staff. The Pharmacy and therapeutic committee further constitutes several sub-committees to look after activities and play its role for Neo-plastic drugs, Anti-infective drugs, Cardiovascular drugs, Diuretic drugs, Cardiac glycosides, Hypotensive, Vasodilators, Spasmolytics, Anti-coagulants, Gastrointestinal, Laxative, Autonomic nervous System, CNS agent, Analgesics, Anticonvulsants, Psychotherapeutics, Respiratory, Sedatives and Hypnotics, Endocrinology, Anti-inflammatory, Hormones, and Typhoid.

Role of PTC:

PTC plays a vital role in various activities of the hospital like drug safety, adverse drug reaction, emergency drugs, drug defects reporting, drug utilization review, etc. These all shall be discussed below

1. Role of PTC in drug safety: Drug safety for patients is a moral, legal, and professional obligation of medical and para-medical professionals. Among them, hospital pharmacist is more responsible for drug safety. The hospital pharmacist is responsible for handling, dispensing, and administration of drugs safely. He should develop awareness among staff regarding the safe use of drugs.

• · Narcotic and psychotropic drugs awareness

• · Proper regulations of addictive and habit-forming drugs

• · Availability of safe and sufficient space for drug storage, dispensing in pharmacy,

• · Expired drugs disposal from the pharmacy,

• · Availability of all equipment and facilities,

• · Training schedule to other hospital staff on drug safety,

• · Development of a drug formulary,

• · Separate storage facility for poison,

• · Separate storage facility for drugs to be used externally,

• · Implementation of drug and cosmetic act applicable provisions.

3. Role of PTC in adverse drug reaction: An unintended, unexpected, undesirable, or excessive response to a drug effect is called an Adverse Drug Reaction. The incidence of drug adverse reactions has become more common. Thus it is a must to do needful to prevent drug adverse reaction. If it develops then it must be treated immediately. PTC issues guidelines regarding the adverse drug reaction (ADR) reporting system.  PTC shall facilitate

• · Analysis of each reported ADR,

• · Identification of drugs and patients at high risk for ADRs,

• · Policies and procedures development for the ADR-monitoring and reporting program,

• · Pharmacists, physicians, nurses, risk managers, and other health professionals Responsibilities and interactions for ADR program,

• · ADR program outcome utilization for educational purposes,

• · Development, maintenance, and evaluation of ADR records inside the hospital,

5. Role of PTC in emergency drugs: Drugs critical for patient care and approved by PTC are considered emergency drugs. These emergency drugs must be available in each ward either in a nursing station or near the bedside of patients. PTC decides policies regarding the availability of these emergency drugs. These emergency drugs are packed inside the emergency box. These emergency boxes shall have emergency medicines as well as emergency supplies

   • Decides Emergency Drugs

   • · Monitor Defective Drugs

   • · Review Drug Utilisation

   • · Develop a drug utilization Policy

   • · Medication history maintenance Policy

   • Reporting of serious ADRs to the drug controller of India, the drug controller of the state, DTAB, or the manufacturer (or all)

   • · Important ADRs publication and presentation

     Some examples of emergency drugs are sedatives, opioid analgesics, antiemetics, antiepileptics, corticosteroids, antihypertensives, antiarrhythmics, etc. Some examples of emergency supplies are syringes, needles, tourniquets, etc

6. Role of PTC in drug defect reporting: Drugs are purchased by hospital administration or by the hospital pharmacy. PTC shall monitor the supply of drugs to find out defective drugs supplied by the supplier. In case of a defective supply, PTC informs suppliers and asks the reason for the defective supply. If the supplier does not provide sufficient reason for defective, supply, or fails to provide a reason then PTC can report the matter to the drug controller of the state.

7. Role of PTC in drug utilization review: Prescription of a drug from a medical practitioner, dispensing of the drug by pharmacists, and administration of a drug by nurses, are some steps of drug utilization. PTC must develop adequate policies to control all these activities of drug utilization. Hospital pharmacists need all this information to maintain the medication history of patients. Medication history of patients shall be required for the following information

• · drug interaction, detection, and prevention,

• · Adverse drug reaction detection and prevention,

• · IV additive incompatibilities detection and prevention,

• · Drug-induced disease detection and prevention,

• · Drug toxicity detection and prevention,

• · Promotion of safe and rational drugs

• Alok Bains