Using medicines wisely: The place of the formulary in medicines management
It has long been established that pharmacists have a central role in promoting rational and cost-effective prescribing. In 1986, the Nuffield Report1 highlighted the importance of pharmaceutical advice. Soon after, it was recognised that capturing this advice in the form of a formulary was probably the most effective way of improving prescribing practice.
The concept of formularies has gained ground over the years and now forms the basic foundation of modern medicines management systems. It is particularly relevant in the current climate where medicines management appears to be at the top of the agenda for nearly all NHS trusts.2
Rationale for formularies
Formularies originally started life in hospitals as a collection of commonly prescribed pharmaceutical preparations, produced mainly for reference purposes. As time went on, the hospital formulary was adapted to incorporate the plethora of information on the increasing number and diversity of medicines. However, these new and expensive preparations required ever-increasing funds, and the formulary rapidly turned into a list of restricted medicines.
The modern formulary is much more than just a collection of preparations. It is an excellent source of detailed local prescribing information, incorporating treatment guidelines and summaries of best practice.
The main reason for developing a formulary is to set standards for best practice.3 This should promote high-quality,evidence-based prescribing and reduce variation in the level of treatment provided to patients. A formulary can be used as a tool to rationalise the range of medicines used in standard practice and to prevent the use of ineffective or overly expensive drugs. With a smaller selection of drugs to choose from, prescribing becomes much simpler.
Furthermore, a formulary can assist in controlling drug expenditure and improving accountability through regular audit.
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Citation: Hospital Pharmacist URI: 10976342
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