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Development of Hospital Formulary in Tertiary Care Referral Hospital

Author(s): Divya Raj*, Dilip. C, Sankar.C, Lisa Mary Mani, Lintu Mathew, Abdul Bari M Mambra.

Journal: Journal of Pharmacy Research
ISSN 0974-6943

Volume: 4;
Issue: 8;
Start page: 2537;
Date: 2011;
Original page

Keywords: Hospital formulary | WHO Model List | NEDL | Monographs

Objective: An attempt was made to design and develop a hospital formulary in a multispecialty tertiary level for providing information on the available drugs in the hospital pharmacy to the physicians and other healthcare professionals and thus to ensure efficacy, safety and quality of the drugs to promote rational use,thereby ensuring the availability of drugs according to the needs of the population. To develop drug monograph for the enlisted medications and to compare the prepared hospital formulary with WHO Model Formulary 2004 and Essential Medicine list India, 2003 and WHO 2010. Methods: This study was conducted over a period of one year. A questionnaire with 10 questions was prepared and distributed to the healthcare professionals in the hospital to evaluate the need and desirable format for the required Hospital Formulary.The latest drug list was obtained from the chief pharmacist in the form of softcopy.All drugs present in the drug list were critically evaluated for its need, efficacy, safety, and cost.The selected drugs were classified according to the British National Formulary as the standard format for the formulary list. Monographs were prepared for all the selected 379 drugs in the hospital pharmacy with the following contents: Synonyms, Therapeutic category, Indication, Pregnancy risk factor, Contraindications, Precautions/ Warnings, Adverse reactions, Dosage, Drug interactions, Patient information, Brands available/ strength/ formulation/ cost.Copies of the prepared hospital formulary were given to Medical superintendent, chief medical officer, and chief pharmacist and to Pharmacy and Therapeutic Committee. Results: The prepared hospital formulary contains 379 drugs generic drugs excluding FDCs where the WHO model listconsists of 358 drugs and National drug list consists of 354 drugs including FDCs.The drugs included in the CNS, CVS, Obstetrics Gynaecology and UTI, Respiratory System, Endocrine System, and Musculo skeletal and joint disease were more in Al Shifa hospital formulary. The number of brands included in the preparedformulary is less.In the prepared list 86 drugs were safe to use in pregnancy, drugs used with caution during pregnancy are more of 225 drugs (category C, D, B/D, A/C, and C/D), 20 drugs are contraindicated(category X).Information on generic name, use, contraindication, drug interactions, precautions, ADR, dose, drug price, pregnancy category, lactation, US FDA approval information, synonym and patient information were present in prepared hospital formulary. Conclusion: The prepared hospital formulary was made into handbook and electronic format, the latest version of formulary which can be considered as the first edition. Continuous updation of the drug information is must for the every six months. The transformation of handbook into electronic format made the drug information availableat the fingertip of the healthcare professionals.
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