1. MTP APPROACH TO REDUCE INAPPROPRIATE USE OF MEDICINES Early-Bird Session, 1 April 2004 Sri Suryawati

2. What is MTP  Monitoring - Training - Planning  Adult learning process Description of the recent situation Problem solving & scientific/reality testing 80% 20% Setting the target of improvement Reflection of previous experience M T P

3. Monitoring (problem identification and measurement) When MTP has been running:  To follow up commitments from the previous session  To evaluate the result of improvement  To conclude the achievement  To identify the specific drug use problem  To select a priority problem  To determine drug use indicator(s) and data source  To identify the target of intervention

4. Training (problem solving)  Discuss the problem: why, what are the underlying factors?  Collect supporting information  Collect scientific information, e.g., reference books, standard treatment guidelines, etc.  Decide how to solve the problem  Solve the problem

5. Planning (setting target for improvement)  Set a target of improvement  Set measures to achieve target  Assign who is responsible for the execution of the plan  Set the date for the next MTP session  Assign who will collect and present data in the next MTP session 80% 20%

6. Flow of activities  2-hour MTP meeting  3-4 cycles for each problem  Simultaneous or parallel activities T M P T M P T M P T M P T M P MTP meeting MTP cycle

7. Conducting MTP in hospital  Set up the core MTP team in hospital, with supports from Director  Plan for MTP activities, assign MTP Group(s) involving the targets of intervention  Plan activities in MTP Groups  Identification and involvement of internal resources  Conducting MTP sessions  Periodic evaluations

8. Distribution of activities Approach the professor Provide microbial culture Provide articles Approach the Director Collect indicators MTP teams at ward/unit level MTP team at hospital level

9. Results of the field-test Sardjito Karyadi Sleman Yogya Panti Rapih PKU

10. MTP implementation?  Indonesia (Dr. Intri)  Kingdom of Cambodia (Dr. Sokhan)  Lao PDR (Dr. Bouathong)