formularies

Question 1

What are the fundamental principles of formularies in practice (3)

Answer 1

1. A drug formulary - is a continually updated list of medications and related products supported by current evidence-based medicine and clinical judgement of physicians, pharmacists and other experts in the diagnosis and treatment of disease and preservation of health.
2. RAG criteria - is used to categorise medications to ensure that the level of patient care and monitoring required is appropriate for the healthcare setting e.g. primary, secondary, and tertiary care. It clarifies prescribing responsibilities and helps with the effective transfer of patient care and is often a ‘traffic light’ system but can differ between formularies
3. Shared care agreements - are signed written agreements between a patient, their specialist service and their GP which allows care and treatment received to be safely shared between the hospital and their GP

Question 2

What is the importance of the use of formularies in practice (8)

Answer 2

1. Minimises the range of drugs in use- results in better knowledge of drug use
2. Promotes evidence-based drug therapy
3. Ensures quality and safety
4. Ensures cost-effective drug therapy and prescribing
5. Encourages use of protocols- consistent prescribing
6. Improvement in communication between prescribers and pharmacists
7. Promotes seamless care between hospital practitioners and primary care practitioners.
8. Better stock management

Question 3

What are the different types of formularies and their use in practice (2)

Answer 3

1. Open formulary system: the formulary recommends drugs, but non-formulary drugs are still routinely available for prescribing
2. Closed formulary system: restricted drug list: only medicines included in the formulary may be prescribed

Question 4

what is the role of the pharmacist and their professional, ethical and legal responsibility in formulary development (7)

Answer 4

1. Key role within the Drug & Therapeutics committee;
   
   1. organising agendas for meetings
   2. responding to new drug applications
   3. communicating decisions
2. Help with writing new drug applications
3. Critical appraisal of evidence submitted in new drug applications
4. Provide help to colleagues whenever prescribing issues arise
5. General maintenance of the formulary

Question 5

What is the decision criteria used in formulary development (10)

Answer 5

1. Patient safety
2. Clinical effectiveness
3. Strength of evidence
4. Place in therapy relative to available treatments
5. National guidance and priorities
6. Local health priorities
7. Equity of access
8. Stakeholder views
9. Cost-effectiveness or resource impact
10. Environmental impact