Hospital pharmacy - pharmacist in practice

What is a way a hospital pharmacy can ensure they are delivering the best quality care for patients within a budget?

Creation and adherence to a local formulary

Who may be involved in creating a new formulary?

Pharmacists in hospitals or integrated care boards

What is the term used to describe a list of medicines used for specific indications and developed to suit the local population?

Formulary

What is formulary development based on?

Choosing most clinically effective and cost-effective medicines

What resources can be referenced when developing a formulary?

NICE guidance, local antimicrobial guidance, BNF, drug tariff

What could be the steps in developing a formulary?

• Consulting national or existing prescribing guidance e.g., Cochrane library to identify drug classes/specific drugs that should be included

• Consulting BNF to identify drugs in relevant classes that have the required indication and what the most common dose is

• Refer to drug tariff to identify least costly option based on 1 course/month of treatment

What are some reasons prescribers may not adhere to formularies?

Some clinical reasons, cannot automatically change patients to new favoured drug

What is the hospital pharmacists role in stock management?

Reviewing ward stock, find out if patterns in medications that are short dated or no longer used, review if medicine should be held

What can happen to medications that are frequently used and keep running out in ward stock?

Stock levels reviewed and can be increased to ensure patients not put at risk