Formulary systems

The actual process of managing the formulary system is different in each organization, but there is a common theme between the components that make up... 

ASHP Guidelines on formulary system management. Am J Hosp Pharm 49 648-652, 1992. 

VS Crane. How to use structured decision making in developing therapeutic, cost-effective formulary systems. Hosp Form 28(Oct) 859-867, 1993. 

McEvoy, G.K., Ed., Drug Information 2004, American Hospital Formulary System, American Society of Hospital Pharmacists, Bethesda, MD, 2004, pp. 2896-2923. 

Lilian M Azzopardi studied pharmacy at the University of Malta, Faculty of Medicine and Surgery. In 1994 she took up a position at the Department of Pharmacy, University of Malta as a teaching and research assistant. Professor Azzopardi completed an MPhil on the development of formulary systems for community pharmacy in 1995, and in 1999 she gained a PhD. Her thesis led to the publication of the book Validation Instruments for Community Pharmacy pharmaceutical care for the third millennium published in 2000 by Pharmaceutical Products Press, USA. She worked together with Professor Anthony Serracino Inglott who was a pioneer in the introduction of clinical pharmacy in the late sixties. Professor Azzopardi is the author of Further MCQs In Pharmacy Practice (2006) and MCQs in Clinical Pharmacy (2007) by Pharmaceutical Press. 

The P T committee s primary function is to maintain a drug formulary. Pedersen et al. (2001) showed that 97.5% of hospifals reporfed fhaf formulary development and management was a primary function of a P T committee. However, key elements of managing the formularies are developing and implementing policies that assure safe and effective medication therapy within institutions. These elements were also reported as primary fxmctions by 97.1% of the hospitals surveyed. The following section reviews fhe formulary system and its management. 

Chase SL, Peterson AM, Wordell CJ. Therapeutic interchange program for oral histamine H2-receptor antagonists. Am.. HUh.-Syst. Pharm. 1998 55 1382-1386. Green J. Point the formulary system and the emperor s new clothes. Am.. Hasp. Pharm. 1986 43 2830-2833. 

Principles of a sound drug formulary system, October 2000. http //www.usp.org/ pdf/patientSafety/pSafetySndFormPrinc.pdf, accessed September 14, 2003. 

Selecting Poor formulary system Lack of knowledge when self-selecting medication... 

ASHP statement on the formulary system. Available at www.ashp.org/best-practices/Formulary/Statement, accessed July 28, 2002. 

Formulary systems are an essential tool used in a variety of settings including hospitals, ambulatory clinics, health plans, pharmacy benefit management companies, and government agencies. This tool, if used correctly, promotes rational, clinically appropriate, safe, and cost-effective pharmaceutical care. 

A formulary system goes much beyond a publication or list of drugs. A coalition of national organizations representing health care professionals, government and business leaders has offered this definition ... 

Drug Formulary. System—an ongoing process whereby ti health care organization, through its physicians, pharmacists, and other health care professionals, establishes policies on the use of dmg products and therapies that are the most medically appropriate and cost-effective to best serve the health interests of a given population. ... 

This review of formulary systems covers their history, structure, positive and negative outcomes, and possible future directions. 

In 1965, two significant actions occurred that promoted formulary systems. Medicare administrators borrowed freely from ASHP s publications to create standards for institutional health care resulting in a Medicare bill listing the use of a formulary system among the eligibility requirements of Medicare reimbursement. Also, the loint Commission required an active pharmacy and therapeutics (P T) committee for hospital accreditation. 

Even with these supporting documents and accreditation standards, adoption of formulary systems was not as fast as many anticipated. In the 1970s, two surveys revealed surprising results. In the first, of the 172... 

Medicare-approved hospitals responding, 31 did not have a formulary system in place even though Medicare required one/ The second, looking at academic medical centers with 500 beds or more, found that the majority of formularies analyzed were simple drug lists and were not used to guide prescribing decisions. - ... 

The development of a formulary system within an organization rests with a multidisciplinary committee. In the hospital and health system setting, this is typically called the P T committee. Virtually all hospitals and health-systems have a P T committee.P T committees usually meet six to eight times annually. An ASHP Position Statement on formulary management declares that decisions should be based on clinical, quality of life, and pharmacoeconomic factors that result in optimal patient care. - It advises against decisions solely based on economic factors. The Position Statement also recommends that decisions must include active and direct involvement of physicians, pharmacists, and other appropriate health care providers. This may include dieticians, nurses, administrators and quality management coordinators. 

Formulary system management falls into three general categories drug selection for formulary inclusion, formulary maintenance, and medication use evaluation. 

The formulary system should include a mechanism for patients to receive a drug not listed on the formulary if it is truly needed. A review of these non-formulary drug requests may offer insight into areas where the formulary is not meeting the needs of the health system s patients. This is true if the review reveals that requests for a specific agent are justified and frequent. The review may show that education is needed for the prescriber to steer them toward a more rational formulary choice. 

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