Definition of Hospital Formulary:
A hospital formulary is a continually updated list of medications and related information, representing the current clinical judgment of the medical staff.
It serves as a guide for the safe, effective, and economical use of drugs within the institution.
The formulary system is the method by which a list of preferred drugs is established for use in the hospital.
Purpose and Significance of Hospital Formulary:
Quality Care: It ensures that medications provided to patients are safe, effective, and of the highest quality.
Standardization: It standardizes medication use within the institution. This can lead to reduced medication errors, improved patient outcomes, and consistent patient care.
Economical Use: By narrowing down choices, bulk purchases can be made which may lead to economic benefits.
Therapeutic Guidelines: The formulary can guide the therapeutic choices of clinicians by providing evidence-based recommendations.
Education and Research: It can be a tool for educating healthcare professionals and a basis for clinical research.
Contents of a Hospital Formulary:
1. Introduction:
This may include the purpose of the formulary, the scope, and the authority under which it has been compiled.
2. General Drug Information:
Drug Monographs: Detailed information about individual drugs, including mechanism of action, pharmacokinetics, indications, contraindications, side effects, dosing, and special considerations.
Drug Interactions: Lists potential interactions between drugs.
Side Effect Profiles: Potential adverse reactions of drugs.
Dosing Guidelines: Guidance on how to dose medications, potentially adjusted for special populations like pediatrics or those with renal impairment.
3. Therapeutic Guidelines:
Evidence-based recommendations on how to manage specific diseases or conditions using drugs.
4. Formulary Drug List:
This is the core of the formulary and includes:
Preferred Drugs: Medications that have been reviewed and approved for use within the institution.
Non-Formulary Drugs: Medications that are not routinely stocked but may be available under special circumstances.
Over-the-Counter (OTC) Medications: Commonly used non-prescription drugs.
Special Medications: These might be high-risk medications, those with restricted use, or those that require special monitoring.
5. Restrictions and Special Access Procedures:
Guidelines on how to obtain non-formulary drugs or those that have restrictions.
6. Compounding Information:
For hospitals that compound medications onsite, there may be standard recipes or methods for creating specific compounded formulations.
7. Information on Medical Devices and Supplies:
Some formularies may also include information on specific medical devices, especially if they’re related to drug delivery (e.g., specific inhalers or insulin pens).
8. Administrative Information:
Policies and Procedures: How the formulary is maintained, updated, and who is responsible.
Criteria for Evaluation: This might detail how drugs are added or removed from the formulary.
Members of the Formulary Committee: Often, a multidisciplinary team is responsible for overseeing the formulary, and their names and roles might be listed.
9. Other Resources:
This could include phone numbers for poison control, reference laboratories, or other resources.
10. Appendices:
Any additional resources or references that support the formulary.
Updating and Review of Hospital Formulary:
The hospital formulary is not a static document.
As new medications come into the market, old ones are discontinued, new research emerges, and clinical experiences shape practice, the formulary must be reviewed and updated regularly.
Typically, a formulary committee, which often consists of pharmacists, physicians, nurses, and sometimes administrators, meets regularly to review and make necessary changes.