Pharmacy World and Science

, Volume 21, Issue 2, pp 74–79 | Cite as

Rational pharmacotherapy in The Netherlands: formulary management in Dutch hospitals

  • R. Fijn
  • L.T.W. de Jong‐van den Berg
  • J.R.B.J. Brouwers

Abstract

A survey regarding the management of rational pharmacotherapy was conducted among all Dutch general hospitals in 1998. The response was 99% (n = 120). The presence of a drugs and therapeutics committee and antibiotic policies in Dutch general hospitals appears independent of hospital characteristics. However, formulary agreements and treatment guidelines are less likely to be present in hospitals that employ only 1 pharmacist or those served by community pharmacies. More than half of the hospitals claim to have restrictive formulary agreements. Large hospitals, hospitals in the eastern and southern provinces and those served by hospital pharmacies more often tend to have restrictive agreements compared to small hospitals, hospitals in the northern, central, and western provinces, and those served by community pharmacies. Various methods to impose restriction and ensure formulary compliance are mentioned. It must be noted that hospitals tend to operate rather solely regarding the large number of different formularies. Surprisingly just a small majority of pharmacists evaluates formulary agreements positively as a management tool. Many drawbacks appear to be present. The results of this survey indicate that in the future Dutch hospitals will favour disease management (treatment guidelines) over drug management (formulary agreements) in the management of rational pharmacotherapy and that information technology will be used to influence clinicians' prescribing behaviour.

Pharmacotherapy Hospital pharmacists Formulary management Formulary agreements Formularies Prescribing restriction The Netherlands D&T committees Antibiotic policies Drug management Disease management Treatment guidelines 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bochner F, Burgess N, Dean Martin E. Approaches to rationing drugs in hospitals. An Australian perspective. Pharmacoeconomics 1996;10:467-74.Google Scholar
  2. 2.
    Bochner F, Martin E, Burgess N, Somogyi A, Misan G. Controversies in Treatment. How can hospitals ration drugs? BMJ 1994;308:901-8.Google Scholar
  3. 3.
    Thürmann P, Harder S, Steioff A. Structure and activities of hospital drug committees in Germany. Eur J Clin Pharmacol 1997;52:429-35.Google Scholar
  4. 4.
    Rascati K. Survey of formulary system policies and procedures. Am J Hosp Pharm 1992;49:100-3.Google Scholar
  5. 5.
    Hogerzeil H. Promoting rational prescribing: an international perspective. Br J Clin Pharmacol 1995;39:1-6.Google Scholar
  6. 6.
    Sloan F, Gordon G, Cocks D. Hospital drug formularies and use of hospital services. Med Care 1993;31:851-67.Google Scholar
  7. 7.
    Hepler C. Where is the evidence for formulary effectiveness? Am J Health Syst Pharm 1997;54:95Google Scholar
  8. 8.
    Horn S. Unintended consequences of drug formularies. Am J Health Syst Pharm 1996;53:2204-6.Google Scholar
  9. 9.
    Dutch Care Federation. List of Addresses 1997.Google Scholar
  10. 10.
    Royal Dutch Society for the Advancement of Pharmacy. List of Addresses 1997.Google Scholar
  11. 11.
    Dutch Association of Clinical Pharmacology. List of Addresses 1997.Google Scholar
  12. 12.
    Dutch Association of Hospital Pharmacists. Tasks and functions of the hospital pharmacy (Dutch) 1980.Google Scholar
  13. 13.
    Rucker T, Schiff G. Drug formularies: myths-in-formation. Med Care 1990;28:928-42.Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • R. Fijn
  • L.T.W. de Jong‐van den Berg
  • J.R.B.J. Brouwers

There are no affiliations available

Personalised recommendations