Hospital formularies: need for continuous intervention.

Feely, J.; Chan, R.; Cocoman, Lelia; Mulpeter, K.; O’Connor, Patricia

doi:10.1136/bmj.300.6716.28

Cited by 36 publications

(10 citation statements)

References 9 publications

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“…Moreover, because of our retrospective design, a Hawthorne e ect (overestimated HDF adherence) has been avoided. A more serious weakness of our research is that we were unable to take the variation in the manner and extent to which pharmacy sta enforces the HDF over time (e.g., soon after the introduction of a new HDF edition), between hospitals, and for di erent medical specialties, individual prescribers, or even drugs groups into account [18,51,52]. However, routine hospital services satisfaction research has shown that the HDF management is equally enforced and similarly appreciated across all hospitals, all medical specialties, and all drug groups.…”

Section: Discussionmentioning

confidence: 99%

“…Our ®ndings cannot con®rm this perception either. A regular turnover may cut both ways, as newly a liated prescribers may either be uncertain and therefore intentionally HDF-adherent in their new practice environment, or, conversely, su er from old prescribing habits originating from the former practice a liation not concurrent with the present HDF [16,18].…”

Section: Discussionmentioning

confidence: 99%

“…Interpretation of non-adherence is also an ambiguous issue, because it involves several factors that are methodologically hard to address validly. Among these factors are prescriber attitudes, the quality of the prescribing tool, implementation issues, and ine ciencies within the hospital health care delivery system [16,18,44,45,46]. Nonetheless, pharmacists have demonstrated creativity, competence, and important skills in drug management.…”

Section: Discussionmentioning

confidence: 99%

“…Among educational and administrative programmes, application of pharmacotherapeutic treatment guidelines (PTGs) and hospital drug formularies (HDFs) are considered e ective [17,18,19,20,21,22,23]. HDFs were ®rst introduced about 40 years ago in Northern America and have been used worldwide as managerial tools ever since.…”

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confidence: 99%

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Assessment of indicators for hospital drug formulary non-adherence

Fijn

Lenderink

Egberts

et al. 2001

Eur J Clin Pharmacol

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Background: Translation of rational drug therapy into practice remains an international problem. Although pharmacotherapeutic treatment guidelines (PTGs) as managerial tools are favoured over hospital drug formularies (HDFs), the latter are still applied in most hospitals. HDF enforcement often leads to timeconsuming consultation from the perspective of both pharmacy sta and prescriber. So far, research on HDFs has only been conducted outside Europe. Moreover, this research has only been descriptive. Straightforward indicators qualitatively characterising HDF non-adherence have never been assessed. Methods: A retrospective 1:1 case-control study was conducted across three general teaching hospitals. Non-HDF requests were compared with HDF requests. Data were multivariably analysed, considering patient, prescriber, drug, and HDF characteristics as possible indicators for non-adherence. Results: HDF adherence was almost universal across characteristics. Non-adherence was characterised by newly marketed drugs, drugs that were part of patients' pre-admission drug therapy, drugs with many fellow drugs within the drug group on the market, and drugs originating from a drug group for which the HDF was highly restrictive. Contrary to common perception, nonadherence was independent of medical specialty, therapeutic area, and patient characteristics. Conclusion: This research provides an epidemiological framework for hospitals (drug and therapeutics committees) for evaluating pharmacy data on HDF nonadherence. It can be used for educational tailor-made feedback to prescribers and for drug selection when the inclusion of newly marketed drugs is considered or HDF restrictiveness for certain drug groups is reconsidered. Moreover, it demonstrates the importance of a regional approach involving secondary and primary health care to establish continuity in seamless care of drug therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Assessment of indicators for hospital drug formulary non-adherence

Fijn

Lenderink

Egberts

et al. 2001

Eur J Clin Pharmacol

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“…[9][10][11] In contrast to these large formularies, other countries have developed small lists that include only essential medicines. Sweden's "Wise List" of about 200 medications and the United Kingdom's regional short lists are successful examples of cost-effective, context-driven, evidencebased formularies in high-income countries.…”

mentioning

confidence: 99%