Effect of pharmacists' clinical interventions on nonformulary drug use

Packer, Lorrie A.; Mahoney, Charles D.; Rich, Darryl S.; Jeffrey, Louis P.

doi:10.1093/ajhp/43.6.1461

Cited by 8 publications

(4 citation statements)

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“…Evidence presented in this paper corroborates other studies that have demonstrated pharmacist intervention can alter prescribing (39,43). A formulary management system cannot operate without an adequate number of highly trained clinical pharmacists (9) and acceptance of the concept of shared professional care of patients.…”

Section: Discussionsupporting

confidence: 72%

“…Excellent communication and intervention skills are needed for this process to operate smoothly. Pharmacist intervention can significantly influence prescribing (38,43). Table 2 shows examples of pharmacist interventions improving the prescription for a non-formulary drug by the substitution of a superior, less toxic, equivalent, cheaper or no drug.…”

Section: R E S U L T Smentioning

confidence: 99%

“…Ward pharmacists are provided with a list of alternatives to commonly prescribed non-formulary drugs. Packer et al (43) found that pharmacists' interventions on nonformulary drug use were cost-effective and that the rate of success was higher when there was greatest trust and rapport between pharmacists and clinicians. Compliance with formulary policies has also been evident in certain other cases in which clinical firms have been very keen to use a non-formulary drug.…”

Section: R E S U L T Smentioning

confidence: 99%

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The Management of a Hospital Formulary

1990

J Clin Pharm Ther

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This paper describes the management of a hospital formulary that is operated by voluntary co-operation of prescribes. The organizational and philosophical factors associated with the formulary management system in a major teaching hospital environment are discussed. A combination of educative, re-educative, persuasive and facilitative strategies is used to influence prescribing behaviour. Both passive and active methods, including face-to-face intervention methods are practised. The formulary is reinforced with an extensive pharmacy monitoring operation which stimulates facilitative dialogue between pharmacists and prescribers and encourages medical self-audit and peer review. Evidence of compliance with recommended policies, and consequent control of drug expenditure are presented.

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Section: Discussionsupporting

confidence: 72%

Section: R E S U L T Smentioning

confidence: 99%

Section: R E S U L T Smentioning

confidence: 99%

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The Management of a Hospital Formulary

1990

J Clin Pharm Ther

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“…The cost avoidance resulting from converting a NFM to one in the formulary increased 5-fold in one study. This cost outweighed the cost of the pharmacist's time required to make the intervention [15]. Similarly, the mean drug acquisition costs per order when a NFM was dispensed were higher than the cost of converting a NFM to a formulary alternative [11].…”

Section: Systemic Hormonal Preparationsmentioning

confidence: 99%

Use of Non-Formulary Medicines at a Kenyan Private Hospital

Mariita¹,

Gadhia²

2023

JBM

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Background: Hospital formularies are used to encourage the use of safe, effective and most affordable medications. Institutions need to make provisions for non-formulary medicines (NFM) due to the dynamic nature of diseases and their management. The aim of this study was to describe the patterns of non-formulary medicine prescriptions at the Nairobi Hospital, the reasons for their purchase as well as the duration taken to avail them. Methods: A descriptive review of all the non-formulary medicine prescriptions from January 2021 to June 2022. The medicines were listed and categorized according to the WHO Anatomical Therapeutic Chemical (ATC) classification system. Correspondence between pharmacy and procurement was reviewed to understand the reason for the requests and the duration it took to avail the medicines. Results: A total of 183 NFM were purchased, with a general increase in the number from January 2021 to June 2022. Vitamins, Mineral supplements and General nutrients accounted for 41 (22.4%) of the NFM. Dermatologicals 27 (14.6%), Genito-urinary system drugs and sex hormones 20 (10.9%), Ophthalmologicals 14 (7.6%) and Antineoplastic and Immunomodulating agents 12 (6.6%) were also frequently purchased out of formulary. The main reasons for NFM purchases were: having no therapeutic equivalents in the hospital formulary 72 (39.3%) and prescriber or patient preference 69 (37.7%). It took a median (IQR) of 4 (2 -7) days for the pharmacy to avail these drugs; with 18.6% being availed in 1 day and 55.2% taking more than 3 days. For the NFM where no alternative was available in the hospital formulary, sales amounted to USD 63,362 which was 79.1% of the value of all the NFM sales. Conclusion: There's a need to regularly update the hospital formulary and to emphasize to the prescribers the importance of adhering to it, as much as possible.

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Nonformulary drug requests at an academic hospital in Germany - the role of general practitioners' long-term medication

Himmel

Lönker²,

Kochen³

1998

European Journal of Clinical Pharmacology

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Since nonformulary requests attributable to previous outpatient medication accounts for less than 20% and since only a minor portion of them lack scientific proof of efficacy we suggest that hospital doctors and clinical pharmacologists should avoid a drug policy, which is too restrictive, and support maintenance of chronic medication initiated by general practitioners. Especially in the department of psychiatry, nonformulary requests seem to be justified by patient needs.

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Effect of pharmacists' clinical interventions on nonformulary drug use

Cited by 8 publications

References 0 publications

The Management of a Hospital Formulary

The Management of a Hospital Formulary

Use of Non-Formulary Medicines at a Kenyan Private Hospital

Nonformulary drug requests at an academic hospital in Germany - the role of general practitioners' long-term medication

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