8INTERNATIONAL RESEARCH & OPINION

Role for community phannacistsin drug fonnulaty development

Community pharmacists play an integral part in thesuccessful development of general practice drugformularies, according to the findings of projectconducted at Brent and Harrow Family Health ServicesAuthority (FHSA) in the UK.

Formulary development within the FHSA wasinitially considered 7 years ago as an approach toencourage rational and cost-effective prescribingpractices. However, because of variations betweenindividual general practices and their populations, it wasdecided to focus on the needs of individual practices,rather than generalise across the FHSA population.

Agreement by all healthcare providersThe formulary project, which was first developed

in 1991, involves pharmaceutical advisors andcommunity pharmacists working together with generalpractitioners to compile and continually update practiceformularies. The formularies comprise comprehensivedisease management guidelines, including drugtherapy, rather than simply lists of preferred medicines.Drug formularies have been constructed using thefollowing steps.• Agree on criteria for selecting drugs, based on

efficacy, appropriateness, acceptability, safety andeconomy.

• Identify general practitioners' current prescribingpractices, based on Prescribing Analysis and CosT(PACT) data and repeat prescribing practices.

• Consider local hospital policies and treatmentguidelines.

• Reach an agreement or consensus on the formularydecisions.

• Agree on the how changes to prescribing practicesshould be implemented.

• Review prescribing practices on a regular basis toensure that formulary guidelines are being adhered to.

'Ongoing monitoring ofprescribing data and drugexpenditure has provided strong evidence that thisinitiative has improved the quality ofprescribing byGPs and contributed greatly to cost containment',concludes Anna Jenkins, a pharmaceutical advisor atthe Brent and Harrow FHSA.

Jenkins A. (5) Fonnu1ary development by community pharmacists.Pharmaceutical Journal 256: 861-863. 22 Jun 1996 ...."".

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