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Pilot drug and therapeutic committee program in Sierra Leone: a descriptive mixed method study
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  • John Kabba,
  • Mark Koroma,
  • Peter James,
  • Chenai Kitchen,
  • Sen Xu,
  • Jie Chang,
  • Amna Saeed,
  • Usman Malik,
  • Minghuan Jiang,
  • Yu Fang
John Kabba
Xi'an Jiaotong University
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Mark Koroma
Southern Medical University
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Peter James
University of Technology Sydney
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Chenai Kitchen
Xi'an Jiaotong University
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Sen Xu
Xian Jiaotong University
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Jie Chang
Xi'an Jiaotong University
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Amna Saeed
Xi'an Jiaotong University
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Usman Malik
Xi'an Jiaotong University
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Minghuan Jiang
Xi'an Jiaotong University
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Yu Fang
Xian Jiaotong University
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Abstract

Introduction Irrational medicine use is proportionately higher in low and middle-income countries like Sierra Leone. This study aims at exploring the structure, functions, and challenges of Drug, and Therapeutics Committees (DTC) recently piloted in Sierra Leone. Method A two-phase mixed-method study design was used in this study. Firstly, a cross-sectional survey using an online questionnaire to assess the structure, indicators, and challenges of DTC . In phase two, a semi-structured interview was used to get deeper insights into the key issues that emerged from the survey. Participants were mainly pharmacists in-charge at the hospitals where the DTC program hasbeen established. MS Excel 2019 and NVivo version 12 were respectively used for data management and analysis. Results DTCs mostly had a minimum of ten members consisting of a mix of both medical and hospital administrative staff. The main functions of DTC are ensuring rational medicines use, monitoring, and reporting adverse drug reactions. All but one hospital had subcommittees that are either effective or nonfunctional. The main challenges in DTC functions and maintenance were funding (n=6), DTC decision implementation (n=4), and unmotivated members (n=4). Strategies suggested to improve DTC at public hospitals and nationwide include; resource allocation, monitoring, and evaluating DTC functions and capacity building of its members. Conclusion DTC present a compelling opportunity towards achieving rational medicines use at the hospital level in Sierra Leone. Nonetheless, lack of funding, operational resources, are significant limitations. Policymakers must note these drawbacks whilst expanding DTC programs to other hospitals in Sierra Leone.

Peer review status:UNDER REVIEW

10 Sep 2020Submitted to British Journal of Clinical Pharmacology
11 Sep 2020Assigned to Editor
11 Sep 2020Submission Checks Completed
17 Sep 2020Reviewer(s) Assigned