Formulary management challenges and opportunities: 2020 and beyond ‐ an opinion paper of the drug information practice and research network of the American College of Clinical Pharmacy

Johnson, Steven T.; Gosser, Rena A.; Kier, Karen L.; Anderson, Keri C.; Douglas, Janine; Heindel, Gregory A; Majerczyk, Daniel; Manian, Radha; Thornby, Krisy-Ann

doi:10.1002/jac5.1332

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…The overuse of alert systems have resulted in alert fatigue, which desensitized the prescribers to the importance of the alerts and thus led to increased formulary noncompliance. 15 Systems that give too many options for selection may also lead to choice overload and impede decision making. 16 Hence, IT systems should also be user-friendly and well aligned with the prescribers’ workflow to increase its acceptability among healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Determination of the Enablers and Challenges in the Implementation of Pharmacy-based Antimicrobial Stewardship (AMS) Program in a Level 3 Hospital in Manila

2023

Acta Med Philipp

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Background and Objectives Antimicrobial resistance (AMR) is a global public health threat that results from misuse and overuse of antimicrobials. The Department of Health (DOH) institutionalized the Antimicrobial Stewardship (AMS) Program in hospitals, based on the core elements (1) Leadership, (2) Policies, Guidelines, and Pathways, (3) Surveillance Antimicrobial Use (AMU) & AMR, (4) Action, (5) Education, and (6) Performance Evaluation to ensure rational use of antimicrobials and improve patient outcomes. The program implementation will require the involvement of the AMS clinical pharmacist to positively influence the success of the program’s implementation. This study aims to identify the enablers and challenges as perceived by AMS clinical pharmacists in the implementation of an AMS program in a level 3 hospital in Manila. Methods A quantitative descriptive study design was employed by administering an online 50-item survey questionnaire to AMS pharmacists, who have at least six (6) months of experience as an AMS pharmacist in the hospital. The survey questionnaire was validated by an expert consultant and underwent pre-testing (Cronbach α = 0.983) for acceptable internal consistency. Responses were collated, coded, and analyzed using median values and frequency distributions for each questionnaire item per Department of Health (DOH) Core Element. Items garnering a median of >3.50 up to 5 were considered as perceived enablers, while those ≤3.50 were identified as perceived challenges. Results Some perceived enablers by the AMS pharmacists include presence of a leader and/or clinician in the AMS team, Information Technology (IT) resource availability, clear roles of AMS pharmacists, readily available hospital AMS guidelines, engagement in AMR and AMU surveillance activities, regular performance of AMS interventions (e.g., IV-to-PO conversion, dose optimization, de-escalation of broad spectrum), regular monitoring and evaluating of prescriptions and prescribing behavior, and continuous education on infection, prevention, and control (IPC) and hygiene. On the other hand, some perceived challenges include insufficient funding, inadequate knowledge in interpreting antibiograms, lack of adequate and specialized training sessions, lack of coordination with medical and nursing staff to ensure timely drug administration and automatic stop order, prescribing of non-Philippine National Formulary (PNF) antimicrobials, lack of time to perform AMS activities, lack of qualified personnel, and lack of hospital management and information technology (IT) support. Conclusion Empowering AMS clinical pharmacists is vital to addressing the perceived challenges and maximizing the perceived enablers to ensure the successful implementation of the AMS program in the hospital.

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Section: Discussionmentioning

confidence: 99%

Determination of the Enablers and Challenges in the Implementation of Pharmacy-based Antimicrobial Stewardship (AMS) Program in a Level 3 Hospital in Manila

2023

Acta Med Philipp

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“…Review of a health system's formulary is vital to ensure the safest, most effective, and most fiscally responsible medications are available for use. 1,2 The Joint Commission (TJC) requires health systems perform annual review of their formulary for efficacy and safety; however, guidance for how to perform this review is lacking. 3,4 Most strategies involve an iteration of a pharmaceutical class review, which entails evaluation of medication entities within each pharmaceutical class for new efficacy, safety, and cost data.…”

Section: Introductionmentioning

confidence: 99%

Use of an Innovative Pharmaceutical Class Scoring Tool for Prioritized Annual Formulary Review

et al. 2022

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Background: Though The Joint Commission requires health systems perform annual formulary review, guidance for how to perform this review is lacking. Published methods include comprehensive review of all pharmaceutical classes; however, this approach may not be the most efficient or effective option for a health system with a large formulary. Objective: To create a prioritization system for annual formulary review through development of a pharmaceutical class scoring tool. Methods: Drug information pharmacists developed the scoring tool, which used external and internal data to score pharmaceutical classes in 4 categories: safety, efficacy, cost, and utilization. The primary outcome, number of formulary changes resulting from pharmaceutical class review, was compared between the highest-scoring and lowest-scoring class to assess the tool’s ability to prioritize high-yield class reviews. Results: The tool calculated scores for 91 pharmaceutical classes, altogether containing 962 medications. After review of the highest-scoring class, corticosteroids, 2 formulary changes were made: one dosage form was removed from formulary, and one medication was restricted to outpatient use only. Zero formulary changes resulted from review of the lowest-scoring class, pharmaceutical adjuvants. Conclusions: The tool described in this study prioritized annual formulary review efforts by identifying a pharmaceutical class with meaningful formulary optimization opportunities as the highest-scoring class, while correctly identifying a class with no optimization opportunities as the lowest-scoring class.

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Clinical pharmacy services in acute care setting during mass gatherings (Hajj): Insights from a task force

Aljuhani

Sulaiman

Bekairy

et al. 2024

Journal of Infection and Public Health

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Formulary management challenges and opportunities: 2020 and beyond ‐ an opinion paper of the drug information practice and research network of the American College of Clinical Pharmacy

Cited by 4 publications

References 29 publications

Determination of the Enablers and Challenges in the Implementation of Pharmacy-based Antimicrobial Stewardship (AMS) Program in a Level 3 Hospital in Manila

Determination of the Enablers and Challenges in the Implementation of Pharmacy-based Antimicrobial Stewardship (AMS) Program in a Level 3 Hospital in Manila

Use of an Innovative Pharmaceutical Class Scoring Tool for Prioritized Annual Formulary Review

Clinical pharmacy services in acute care setting during mass gatherings (Hajj): Insights from a task force

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