Tan Ee Lyn, Day Richard O, Brien Jo-anne E
Faculty of Pharmacy, The University of Sydney, Sydney, Australia.
Res Social Adm Pharm. 2005 Dec;1(4):526-45. doi: 10.1016/j.sapharm.2005.09.001.
Drug and therapeutics committees (DTCs) are expected to make difficult decisions that may have an impact on the clinical and economic outcomes of drug use. There have been few studies investigating the barriers to DTC policy implementation, and little is known about ways to improve the process.
The specific objectives of this qualitative study were to explore stakeholder opinions with respect to (1) the perceptions of barriers to Drug and Therapeutics Committee (DTC) policy implementation and (2) ways to improve DTC policy implementation.
Stakeholders of Australian DTCs participated in focus group discussions. Discussions were audiotaped and transcribed verbatim. Thematic content analysis was conducted.
Six focus group discussions were conducted. A number of barriers were identified (lack of resources, lack of follow-up, lack of ownership, low DTC profile within the organization, and overreliance on pharmacy to implement policy). Participants were of the opinion that prioritizing decisions, optimizing pharmacy roles, provision of real-time information, and active procurement of organizational commitment were some of the ways to improve DTC policy implementation.
Although this study was conducted in an Australian setting, the challenges facing DTCs in other countries are likely to be similar. Ownership, social influence, and resources are important issues in the implementation of policy/guidelines for many DTCs, both in Australia and internationally. It is expected that these issues will have an impact on policy implementation. Therefore, the findings of this study may be widely applicable. This work reinforced the notion that the significance of DTCs lies beyond decision making alone. The time and expertise invested in decision making could be undermined, if DTC policies are not effectively implemented.
药物与治疗学委员会（DTCs）需要做出可能会对药物使用的临床和经济结果产生影响的艰难决策。很少有研究调查DTC政策实施的障碍，对于改善这一过程的方法也知之甚少。
这项定性研究的具体目标是探讨利益相关者对于（1）药物与治疗学委员会（DTC）政策实施障碍的看法，以及（2）改善DTC政策实施的方法。
澳大利亚DTC的利益相关者参与了焦点小组讨论。讨论进行了录音并逐字转录。进行了主题内容分析。
进行了六次焦点小组讨论。确定了一些障碍（资源不足、缺乏跟进、缺乏自主权、DTC在组织内的知名度低以及过度依赖药房实施政策）。参与者认为，对决策进行优先排序、优化药房角色、提供实时信息以及积极争取组织承诺是改善DTC政策实施的一些方法。
尽管这项研究是在澳大利亚进行的，但其他国家的DTC面临的挑战可能类似。自主权、社会影响力和资源是澳大利亚和国际上许多DTC实施政策/指南时的重要问题。预计这些问题将对政策实施产生影响。因此，本研究的结果可能具有广泛的适用性。这项工作强化了这样一种观念，即DTC的重要性不仅仅在于决策本身。如果DTC政策没有得到有效实施，投入到决策中的时间和专业知识可能会被削弱。
