Entrenching the KNH Formulary to Clinical Practice DR WK SIGILAI MTC CHAIR

Used to be drug- list based Now it’s a comprehensive system of medication use policies to ensure safe, appropriate use of pharmaceuticals MTCs now have broader functions – ADR reporting, development of STGs, Mx of drug product shortage

KNH Formulary launched in September, 2013 Development process had taken a long time Over 500 copies distributed to UON & KNH staff, clinical areas, pharmacy units KNHF used to review KNH tender list For the document to be useful, collective responsibility is required

Formulary management is dynamic Information on existing medicines changes, new products coming into the market Hospital has to control what medicines they stock Ideally, the formulary lists should be developed from STGs During development of KNH formulary, National guidelines were used. Some specialized areas not adequately covered by the National STGs

Importance of a formulary Guide prescribing therefore improve medication use Improve availability of medicines by focusing on the Vital and Essential Medicines Improve budget utilization by rational allocation of funds

Pharmacy role Ensure 100% availability of vital & essential medicines – this will ensure access to medicines and limit patients bringing their own medicines to hospital Conduct medication use reviews Report to the MTC and inform other team members of changes in prescribing patterns, guideline updates Audit utilization of non – essential and non – formulary medicines and report Ensure adherence to policies established esp for non – formulary medicines

ENTRENCHMENT To make part of a system/institution To ensure sustenance/longevity To protect the formulary

Requirements Institutional commitment to support formulary Budgetary allocation for MTC activities Capacity building especially training of pharmacists and other stakeholders Elevate profile of the MTC Regular sensitization esp of new staff

CULTURE CHANGE Consider where we are coming from Persuading all clinicians to adopt the formulary Enhancement of communication between pharmacy and prescribers System of sanctions may be considered

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