DEVELOPMENT OF AN INDICATOR BASED TOOL FOR THE ASSESSMENT OF MEDICINES SELECTION PRACTICES IN VARIOUS PUBLIC SECTOR HOSPITALS

Mir Javid Iqbal; Mohammad Ishaq Geer; Parvez Ahamd Dar

doi:10.22159/ijpps.2016v8i11.14536

Authors

Mir Javid Iqbal Department of Pharmaceutical Sciences, University of Kashmir, Srinagar-190006, J&K, India
Mohammad Ishaq Geer Department of Pharmaceutical Sciences, University of Kashmir, Srinagar-190006, J&K, India
Parvez Ahamd Dar Department of Paediatrics, Govt. Medical College, Srinagar-190001, J&K, India

DOI:

https://doi.org/10.22159/ijpps.2016v8i11.14536

Keywords:

Indicator, Assessment, Selection, Tertiary care, National List of Essential Medicines

Abstract

Objective: To develop and validate an indicator based assessment tool for carrying out an in-depth assessment of drug selection practices prevalent at various public health facilities.

Methods: The study was designed across the different levels of healthcare settings. One super specialty children's tertiary care hospital (CH), one government medical college hospital (MCH), one district hospital (DH), one sub-district hospital (SDH) and one primary health center (PHC) was selected for the study. A set of 29 qualitative and 7 quantitative indicators was developed and validated to evaluate and assess drug selection practices in these public healthcare facilities.

Results: All the surveyed healthcare facilities managed and stored essential medicines except solid oral dosage forms, contraceptives, antiretrovirals and anti-tubercular drugs. The selection process for medicines was not carried out at SDH and PHC level. National List of Essential Medicines (NLEM), manufacturer's information, and expert faculty opinion were used as basic tools for carrying out a selection of drugs. None of the facilities were found to have Drugs and Therapeutics Committee (DTC) in place or its own Hospital Formulary (HF). Insufficient and irregular disbursement of funds was found to be the main constraint in selecting drugs for procurement. None of the facilities had any policy and procedural manual or standard operating procedures for governing their drug selection and quantification processes. Quantitative assessments showed that disbursement of the budget was fragmented. On the basis of NLEM children's hospital was found to have highest medicines percentage availability of eighty percent (80%) with the lowest at SDH and PHC of twenty percent each (20%). Facility wise percentage adherence to various indicators for policies and procedures was found to be 50% in MCH, CH, and DH respectively and 66.6% adherence for NLEM indicator was recorded in MCH, CH and DH respectively.

Conclusion: Drug selection process for public health facilities is a highly technical and professional activity that can only be achieved efficiently by having a well-defined document containing Standard Operating Procedures (SOPs) and comprehensive policy framework for drug selection, quantification, procurement, storage, distribution, and use besides having suitably qualified, adequately trained, sufficiently skilled manpower both at managerial and ground level.

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