ABSTRACT
<b>Objective: </b>A hospital Formulary (HF) is useful not only for providing a list of formulary drugs, but also for drug safety management and clinical practice in hospitals. Our Pharmacy Division serves as a clinical training facility for the Faculty of Medicine and offers a bedside learning (BSL) program that allows students to participate in medical services. Providing medical students with a requisite understanding of pharmacotherapy in order to effectively provide medical services is the goal of the core curriculum of medical education and HF use in BSL may be effective in achieving this goal. We conducted a survey in order to examine the usefulness of an HF for medical students during clinical training and to determine what drug information is required by students.<br><b>Methods: </b>Between April 2012 and March 2013, a questionnaire survey was conducted on 88 fifth-year medical students who participated in a 1-day BSL program using an HF.<br><b>Results: </b>The response rate was 100%. All students responded that they understood how to use the HF and believed it was useful in BSL. However, the level of satisfaction with the explanatory notes was significantly lower than that of other sections providing clinically useful additional information such as monographs or supplementary tables (<i>p</i><0.05). More than 80% of the students considered monographs to be useful for obtaining information on side effects, warnings and contraindications, dosage and administration, indications, dosing in renal impairment, and drug name. Students generally considered supplementary tables useful for obtaining information on serious side effects and their early identification, points of drug use in renal dysfunction, appropriate drug use in cancer chemotherapy, insulin and diabetes treatment, calculations of pediatric dosing, and a list of clinically used abbreviations.<br><b>Conclusion: </b>These results suggest that medical students believe an HF is useful in BSL. When medical students participate in pharmacotherapy during BSL programs outside the Pharmacy Division, an HF that not only lists drugs but also contains supplementary tables of clinically useful information may be required.
ABSTRACT
The objective of this study is to compare the use of antibiotics at the Metropolitan Medical Center Hospital in Jakarta, Indonesia (MMCH), before and after the implementation of a hospital formulary. All antibiotic data under J01 Anatomical Therapeutic Chemical (ATC) classification were collected from pharmacy inpatient and outpatient records. Quantitative antibiotic use was expressed in Defined Daily Doses/100 bed-days (DDDs/hbd) for inpatients and DDDs/1000 patients/day (DDDs/tpd) for outpatients. The general quality of drug use was assessed in number of drugs that account for 90% of the use (DU90%) and the adherence to hospital formulary by substance and brand name within the DU90% segment. Quantitative and qualitative antibiotic use were compared before and after implementation of the formulary (1999 to 2000). The Wilcoxon rank sign test was used to compare overall antibiotic use. Inpatient antibiotic usage decreased significantly by 23.1%, 124.96 DDDs/hbd in 1999 to 96.13 DDDs/hbd during 2000 (p= 0.03) and outpatient antibiotic usage decreased insignificantly by 4.9%, 3.49 DDDs/tpd during 1999 to 3.32 DDDs/tpd during 2000 (p=0.58).The most commonly antibiotic use was ciprofloxacin in inpatient setting during the study and in out-patient setting was amoxicillin in 1999 and ciprofloxacin in 2000. The adherence to the formulary by substance and by brand name in inpatient department was 100% and 90.5% and in outpatient department was 100% and 94.3% during the study. DU 90% by substance name and by brand name was considerably not improved in both settings. The conclusion is that the effectiveness of one year formulary implementation at MMCH was only revealed in inpatient setting.