Drug and Therapeutics (D & T) committees in Dutch hospitals: a nation-widesurvey of structure, activities, and drug selection procedures

Aims To determine structure, activities and drug selection processes used b y Dutch hospital drug and therapeutics (D & T) committees. Methods A pretested structured survey questionnaire based on the Australian process and impact indicators, previous research, and consultation of prof essionals was developed. Subsequently, D & T committees that met predefined selection criteria were asked to participate. Results The overall response rate was 70% (38/54). D Pc T committees varied considerably in size and representation of clinical expertise. Although re sponsibilities were theoretically alike, actual responsibilities were frequ ently passed on to other authorities, such as pharmacy staff: Few committee s used detailed guidelines or decision supportive matrices to establish tra nsparency in drug selection. With respect to drug selection, the value scor es on the information resources used, the factors involved, and the selecti on criteria used varied. Hospital pharmacists were likely to be most involv ed and to have the greatest impact. A consensus was most difficult to achie ve for drugs used in cardiology, oncology, and psychiatry, interference of industrial marketing strategies on drug selection was recognized and identi fied. Conclusions Our results indicate that Dutch hospital D & T committees diffe r with respect to their clinical expertise and their activities, a situatio n comparable with that observed in other countries. Furthermore, the lack o f transparency in drug selection was considerable. These findings clarify t he differences previously found between Dutch hospital drug formularies.