GRP-123 Non Formulary Drug Management – Absurd or Reasonable?

Background Non-formulary drugs are prone to cause medication errors due to their less common use in the daily routine on the ward. Therefore non-formulary drug (NFD) management in the hospital pharmacy includes checking the dose and indication which is usually very time consuming. In 2010 the drug information centre had to deal with 12,903 prescriptions for NFDs. Purpose Loss of relevant drug information at the interface between pharmacy and ward has been observed in some cases. Therefore a survey was performed to detect information gaps. Did the pharmacist’s recommendation reach the medical staff? Materials and Methods During a period of four weeks all NFD prescriptions were documented concerning the type of medicine. If a treatment-relevant intervention (e.g. dose correction) was made the trainee pharmacist visited the ward to clarify if the pharmacist’s advice was received. In addition the medical staff were interviewed about the general procedure of information transfer within the ward staff. Results 1158 NFDs were ordered. Out of these 261 required extensive action with pharmacist intervention. 256 interventions were accepted on the ward and only 5 were rejected. In only one case out of these the pharmacist’s information had to be resupplied to the ward as it had not reached the staff. The survey showed a very high acceptance (98.1%) of the drug information provided. 83 drugs within the ATC Code “antibiotics for systemic use” were particularly counselling-intense. Dosing problems were the most frequent drug-related problem (52). Information transfer within the ward turned out to be highly inhomogeneous. Conclusions The pharmaceutical advice offered to the ward was accepted to a very high percentage. To prevent information loss on the ward a standardised system for information transfer amongst the staff needs to be established. No conflict of interest.