EVALUATION OF TYPE C HOSPITAL FORMULARY IN YOGYAKARTA - PowerPoint PPT Presentation

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EVALUATION OF TYPE C HOSPITAL FORMULARY IN YOGYAKARTA

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Many pharmaceutical products on the market are new and non-essential. ... 4 wards (Obstetrics and Gynecology, Pediatrics, Surgery, and Internal Medicine) ... – PowerPoint PPT presentation

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Title: EVALUATION OF TYPE C HOSPITAL FORMULARY IN YOGYAKARTA


1
(No Transcript)
2
  • EVALUATION OF TYPE C HOSPITAL FORMULARY IN
    YOGYAKARTA
  • Anggriani Y, Pudjaningsih D, Suryawati S
  • Department of Clinical Pharmacology, Faculty of
    Medicine,
  • Gadjah Mada University, Yogyakarta

3
Background
  • Many pharmaceutical products on the market are
    new and non-essential.
  • Strong hospital drug policy and instruments is
    needed to manage the hospital formulary list, due
    to increasing number of new drugs being
    introduced to medical doctors.
  • Hospital formulary list is often developed
    without adequate process
  • Even if there is a guideline, the decision is
    often based on individual interest.

Quality of hospital formulary?
4
Objectives
  • To evaluate and to compare the quality of 7
    hospital formularies.
  • To determine the processes used to maintain the
    formulary in each hospital

5
Methods
  • Descriptive-analytical, explorative case study
  • 5 Public and 2 Private Hospitals
  • Seven Hospital Formulary Lists were evaluated
  • Quantitative data total number of drugs on the
    list, number of drugs in brand name, number of
    drugs in generic name, number of essential drugs,
    number of drugs supported by primary literature,
    number of generic drugs available, and the number
    of non-formulary drug procured and kept in stock.
  • Qualitative data
  • In-depth interviews with Drug and Therapeutic
    Committee (DTC) members and representative
    doctors from 4 wards (Obstetrics and Gynecology,
    Pediatrics, Surgery, and Internal Medicine).
  • Observation on minutes of DTC meetings

6
Outcome Measures
  • The quality of hospital formulary was measured by
    looking at some indicators, i.e.,
  • Number of brand-name products
  • Percentages of generic drugs on the list
  • Percentages of essential drugs (drug from NEDL)
  • Percentages of drugs supported with the primary
    literature
  • Percentages of drugs with a single ingredient
  • Percentages of generic drugs kept in stock
  • The process of maintaining a formulary was
    measured by
  • The frequency of revision formulary list
  • Percentage of non-formulary drugs procured and
    kept in stock
  • Observation on minutes of DTC meetings.

7
Results 1 The values of each indicator in 7
hospitals
8
Results 2 Number of non-formulary drugs
vs frequency of revision
9
Results 3 Step in developing hospital formulary
list
  • Listing all drugs available in stock
  • Distributing the existing drug list and drug
    request forms to medical doctors
  • Establishing criteria for drug selection and
    revise formulary in DTC meeting.
  • Parties involved DTC members and Doctors
  • Discussing the requests
  • request is discussed only if attended by doctors
    who request the new drug
  • Official announcement of the new formulary by the
    hospital director.

10
Results 4 Mechanisms of new drug additions into
formulary
  • Hospital B, C, D and E
  • Fill in the drug request form
  • Submit to pharmacy department
  • Discuss drug requests in DTC meeting
  • Distribute supplementary formulary
  • Procured by the pharmacy department

Hospital A, F, G Fill in the drug request
form Submit to pharmacy department Procured by
the pharmacy department
11
DISCUSSION
  • This study found the method was easy to use.
    Therefore, its use in routine hospital evaluation
    is promising, e.g., for accreditation system.
  • Although still far from the ideal, this method is
    sensitive enough to show the difference between
    hospitals. Such instruments can also be used as
    indicators in improving the quality of hospital
    formulary.
  • Hospital formulary list should ideally develop
    from hospital standard treatment guidelines
    (STGs). An indicator should be added to evaluate
    the percentage of active ingredients which are
    not in the STGs.

12
CONCLUSIONS
  • Although no hospital showed ideal formulary list,
    the quality of public hospital formularies was
    relatively better than that of private hospitals
    formularies, due to
  • Tendency of DTC in private hospitals to
    accommodate the doctors request
  • Doctors general perception that essential and
    generic drugs are not sufficient to clinical
    needs
  • The mechanism to manage hospital formulary is not
    well established, mostly because regular meetings
    for formulary revision in not yet established

13
Terima kasih (thank you)
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