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IMPROVING PERFORMANCE OF DRUG THERAPEUTIC COMMITTEES IN LAO P.D.R

This study aims to identify factors impacting the performance of Drug Therapeutic Committees (DTC) in Laos PDR and evaluate the effectiveness of an educational intervention using feedback. The results show that DTC performance significantly improved after the intervention.

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IMPROVING PERFORMANCE OF DRUG THERAPEUTIC COMMITTEES IN LAO P.D.R

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  1. IMPROVING PERFORMANCE OF DRUG THERAPEUTIC COMMITTEESIN LAO P.D.R Vang C1; Wahlstrom R2; Tomson G2. Southammavong T1; Phanyanouvong A1; Kounnavong S1; Sisounthone B1; Keungsaneth P1;Rattanavong S1; Eriksson B 2 , Johansson R2 1 Ministry of Health, Laos 2 International Health Care Research , Karolinska Institute, Sweden

  2. PROBLEM STATEMENT • The Lao PDR is still a developing country. There is still little health care resource. • It is a very important for the Lao PDR the need for • accurate prescribing decision • appropriate treatment • rational use of drug • The development of Standard Treatment Guidelines (STG) was included in the Lao NDPP

  3. STG was aimed to strengthen RUD and to change the attitude and behavior of the physicians in hospitals. • To achieve this goal many DTC have been established in Laos to take over the control of STG and RUD in the Lao PDR. • However, problems with their performance have been reported, and it was not clear how to improve the situation

  4. OBJECTIVES • To determine • factors in the working environment that relate to DTC performance • and whether it could be improved through an educational intervention using feedback targeted towards the DTC members

  5. STUDY DESIGN • Quasi-experimental (before and after) study. • SETTING AND STUDY POPULATION • Nine provincial hospitals and the DTC members from these hospitals were included • INTERVENTION • Feedback sessions using structure and performance indicators

  6. OUTCOME MEASUREMENT • Performance of DTC units was assessed through specifically developed DTC indicators on structure and process combined with RUD and Standard Treatment Guidelines (STG) scores on Malaria, Diarrhoea and Pneumonia • 94 DTC members were interviewed to identify factors, which could impact on DTC performance

  7. Data was collected for three-months periods at baseline and for three consecutive periods • The results of the first three data collections were shown and discussed with the DTC members during feedback sessions • Data recorded in the pre-intervention and post-intervention periods were compared

  8. Process of Intervention, Data Collection and Analysis Comparison 1st DTC members interview with 1st round of DTC, STG and RUD baseline scores collection 2nd and 3 rd rounds of DTC, STG, RUD scores collection 2nd DTC members interview with 4th DTC, STG and RUD scores collection Intervention period (4 months) Pre-intervention period (3 months) Post-intervention period (3 months) feedback feedback feedback 3 educational feedback intervention sessions to DTC members

  9. Changes in DTC Performance After Feedback Intervention by the Research Team (n = 9) * * * * * This is where a large graphic or chart can go.  * * * p < 0.05  p < 0.01

  10. Changes in DTC , STG and RUD Indicators Scores After Feedback Intervention (n = 9) * *  * * This is where a large graphic or chart can go. * p < 0.01  p < 0.001

  11. Positions Held by the Interviewed DTC Members in Hospital Administration (n= 94)

  12. Positions Held by the Interviewed DTC Members in Hospital Administration and DTC Organization (n= 94)

  13. Time Available for DTC Activities (n= 94)

  14. Negative Factors on DTC Performance (n = 94)

  15. CONCLUSIONS • Inefficient DTC performance recorded in the pre-intervention period may be related to that DTC members are overloaded by other works • DTC performance improved significantly after intervention with feedback sessions

  16. RECOMMENDATIONS • Continuous monitoring of the performance by means of the indicators is suggested to improve DTC work • Special attention should be given to areas with low scores like ADR, hospital routines and cost aspects • Adequate time should be allocated for DTC members

  17. Thank You for your attention

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