Pharmacist Lama Al.Homoud Director of Clinical Pharmacy Directorate / MOH MeTA Committee 1: Encouraging best practice & Improve Rational Use of Medicines

Committee Members Dr Taher Abu-ElSamen, HHC, SG Dr Laila Jarrar, JFDA, Drug Director Dr Wafa Nsour, RMS , Pharmacy & Drug Director Dr Khawla Abu Hamour, JUH , Pharmacy Director Dr Sana Naffa, WHO Dr Lama Al. Homoud, MOH, Clinical Pharmacy Director

Dr Taher Abu-ElSamen, HHC, SG

Dr Laila Jarrar, JFDA, Drug Director

Dr Wafa Nsour, RMS , Pharmacy & Drug Director

Dr Khawla Abu Hamour, JUH , Pharmacy Director

Dr Sana Naffa, WHO

Dr Lama Al. Homoud, MOH, Clinical Pharmacy Director

Background Clinical guidelines and treatment protocols are two of the major ways to ensure that the health care treatment options provided to populations are the best and most appropriate that the country could afford

Clinical guidelines and treatment protocols are two of the major ways to ensure that the health care treatment options provided to populations are the best and most appropriate that the country could afford

Background Standardization of protocols in a selected disease area by using the Rational Drug List Increasing the acceptability/impact of RDL and reducing variation/inequity in current practices

Standardization of protocols in a selected disease area by using the Rational Drug List

Increasing the acceptability/impact of RDL and reducing variation/inequity in current practices

Encouraging Best Practice / Improve Rational Use of Medicine Evidence Based Decision Making for the (RDL) Capacity Building in Civil Society Priority Areas in Jordan’s MeTA Workplan

Encouraging Best Practice / Improve Rational Use of Medicine

Evidence Based Decision Making for the (RDL)

Capacity Building in Civil Society

Scope of Work Improve rational use of medicines: Consolidation and implementation of Standard Treatment Guidelines Working with physicians and pharmacists to improve prescribing behavior through training &continuing professional educational programs Promoting the use of standard treatment guidelines

Improve rational use of medicines:

Consolidation and implementation of Standard Treatment Guidelines

Working with physicians and pharmacists to improve prescribing behavior through training &continuing professional educational programs

Promoting the use of standard treatment guidelines

Improve rational use of medicines Strategies adopted by MeTA / Jordan: Strategy I : Assessment and gap analysis Strategy II : Development and Implementation plan for the Standard Treatment Guidelines Strategy III : Evaluation of a pilot area and Multi-Sectoral Dissemination

Strategies adopted by MeTA / Jordan:

Strategy I : Assessment and gap analysis

Strategy II : Development and Implementation plan for the Standard Treatment Guidelines

Strategy III : Evaluation of a pilot area and Multi-Sectoral Dissemination

Strategy I: Assessment and gap analysis Activities : Assessing the current guidelines used in different sectors Performing gap analysis of the current situation; what standards are used, what services are covered, are these standards implemented?

Activities :

Assessing the current guidelines used in different sectors

Performing gap analysis of the current situation; what standards are used, what services are covered, are these standards implemented?

Strategy I: Assessment and gap analysis Activities: Reviewing the perception and use of the existing treatment guidelines Knowledge, Attitude and Practice Study (KAP study) Defining the committee targets and future steps in developing , adopting or consolidating the standards Identifying the scope, purpose and use of these guidelines

Activities:

Reviewing the perception and use of the existing treatment guidelines Knowledge, Attitude and Practice Study (KAP study)

Defining the committee targets and future steps in developing , adopting or consolidating the standards

Identifying the scope, purpose and use of these guidelines

Strategy II: Development and Implementation plan for the STG Activities : Finalizing and approving STG Disseminating the guidelines in the pilot area through orientation and training sessions Involving the Hospital Pharmacy and Therapeutic committees to activate their role in the implementation and monitoring processes

Activities :

Finalizing and approving STG

Disseminating the guidelines in the pilot area through orientation and training sessions

Involving the Hospital Pharmacy and Therapeutic committees to activate their role in the implementation and monitoring processes

Strategy III: Evaluation of a pilot area & Multi-Sectoral dissemination Activities : Evaluate the compliance with STG in the pilot area Prepare an advocacy tool using evidence and figures on cost containment and efficiencies in medicine expenditure Use Multi-Sectoral approach towards a national program to promote rational use of medicines

Activities :

Evaluate the compliance with STG in the pilot area

Prepare an advocacy tool using evidence and figures on cost containment and efficiencies in medicine expenditure

Use Multi-Sectoral approach towards a national program to promote rational use of medicines

Work plan Sub-activities 1- Gap Analysis and situation analysis for the availability and use of STG in health facilities in Jordan: a. Formulate a technical work group from public health institutions (MOH, JFDA, RMS and JUH) b. Design a tool for collecting data regarding availability of the STG and the compliance to these standards c. Conducting a comparative study with international STG d. Analysis of findings, conclusion and recommendations

1- Gap Analysis and situation analysis for the availability and use of STG in health facilities in Jordan:

a. Formulate a technical work group from public health institutions (MOH, JFDA, RMS and JUH)

b. Design a tool for collecting data regarding availability of the STG and the compliance to these standards

c. Conducting a comparative study with international STG

d. Analysis of findings, conclusion and recommendations

Work plan Sub-activities 2- Three regional workshops to build consensus and get feedback from all parties on the final STG draft 3- Finalizing and approving STG 4- produce copies of the STG with job aids, posters and other materials to be used in public health facilities

2- Three regional workshops to build consensus and get feedback from all parties on the final STG draft

3- Finalizing and approving STG

4- produce copies of the STG with job aids, posters and other materials to be used in public health facilities

Performance Progress and Evaluation . Gap analysis and availability of existing guidelines Strategy developed and disseminated Finalization and approval of the STG Dissemination of guidelines in the pilot area Evaluate the compliance with standards in the pilot area Continuing professional education programs

.

Gap analysis and availability of existing guidelines

Strategy developed and disseminated

Finalization and approval of the STG

Dissemination of guidelines in the pilot area

Evaluate the compliance with standards in the pilot area

Continuing professional education programs

Means of Verification Performance Indicators Gap analysis and assessment report finalized Workshop conducted Pilot conducted Report to be delivered CPE Programs done

Gap analysis and assessment report finalized

Workshop conducted

Pilot conducted

Report to be delivered

CPE Programs done

Expected outcomes The establishment of a multi-stakeholder approach that will be working towards increasing transparency focusing on the regulations, selection, procurement, and distribution of medicines Strengthening governance Maximizing cost benefit utilization of medicines by healthcare professionals

The establishment of a multi-stakeholder approach that will be working towards increasing transparency focusing on the regulations, selection, procurement, and distribution of medicines

Strengthening governance

Maximizing cost benefit utilization of medicines by healthcare professionals

National Institute for Clinical Excellence (NICE) An organization that is responsible for providing national guidance on promoting good health A training workshop was conducted by NICE on Using Health Technology Assessment to inform decision-making in healthcare March 2009 Another workshop is planned for mid June 2009 to start with a pilot disease oriented STG (Hypertension)

An organization that is responsible for providing national guidance on promoting good health

A training workshop was conducted by NICE on Using Health Technology Assessment to inform decision-making in healthcare March 2009

Another workshop is planned for mid June 2009 to start with a pilot disease oriented STG (Hypertension)

National Institute for Clinical Excellence (NICE) NICE involvement can be of benefit in two areas of strategic importance for improving the transparency of the way our healthcare system functions: A) Best practice (STG), including harmonization of existing ones and methods and processes of adapting or developing new ones in high burden of disease areas B) RDL including the methods and processes of making and listing and delisting decisions, considerations of cost effectiveness and of affordability

NICE involvement can be of benefit in two areas of strategic importance for improving the transparency of the way our healthcare system functions:

A) Best practice (STG), including harmonization of existing ones and methods and processes of adapting or developing new ones in high burden of disease areas

B) RDL including the methods and processes of making and listing and delisting decisions, considerations of cost effectiveness and of affordability