Drug and therapeutics committees in Nigeria : evaluation of scope and functionality

Fadare, Joseph O. and Ogunleye, Olayinka and Obiako, Reginald and Orubu, Samuel and Enwere, Okezie and Ajemigbitse, Adetutu A. and Meyer, Johanna C. and Enato, Ehijie and Massele, Amos and Godman, Brian and Gustafsson, Lars (2018) Drug and therapeutics committees in Nigeria : evaluation of scope and functionality. Expert Review of Clinical Pharmacology. ISSN 1751-2441 (In Press)

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Introduction: Inappropriate use of medicines remains a problem, with consequences including increasing adverse drug reactions (ADRs) and prolonged hospitalizations. The Essential Medicines List and Drug and Therapeutics Committees (DTCs) are accepted initiatives to promote the rational use of medicines. However, little is known about DTC activities in Nigeria, the most populous African country. Areas covered: A cross-sectional questionnaire-based study was conducted among senior pharmacists, consultant physicians and clinical pharmacologists in 12 leading tertiary healthcare facilities across Nigeria. Expert commentary: Six (50%, 6/12) healthcare facilities had existing DTCs with three (50%) having a sub-committee on antimicrobials. 75% had infection control committees, with presence even in centres without DTCs. Chairpersons and secretaries of the DTCs were predominantly physicians (83.3%) and pharmacists (100%) respectively. Hospital formularies were available in five facilities with DTCs, while one facility without a DTC had an Essential Medicines Committee responsible for developing and updating the hospital formulary. The evaluation of ADRs was undertaken by pharmacovigilance units in nine facilities. Overall, DTCs were present in only half of the surveyed facilities and most were performing their statutory functions sub-optimally. The functioning of DTCs can be improved through government directives and mechanisms for continuous evaluation of activities.