Evaluation of Belgian hospital drug formularies based on quality indicators

Study objectives: The Drug and Therapeutics Committee (DTC) has an essential role in managing the pharmacotherapeutic policy of a hospital. Because the formulary is a guide for appropriate drug selection and a tool for supporting the quality of drug use and cost control, it should be complete, concise and easy to use. The purpose of this study was to evaluate the format, organisation and content of formularies used in Belgian hospitals. Indicators, proposed on the basis of a literature review, were evaluated for validity, clarity and accessibility by two senior and five junior pharmacists. The selected indicators were classified in five groups: technical features, user-friendliness, information on drug procedures, product specific information and guidelines. Points were assigned to each indicator, according to their importance, to give a total of 1,000 points. The formularies were evaluated based on this model. Results: Seventy-three Belgian hospital formularies were evaluated. A current list of the medicines available in the formulary was presented by 69% of the hospitals. A minority of these (24%) were presented in a pocket format. Only a few formularies mentioned the objectives, tasks and constitution of the DTC. Four formularies (5%) contained guidelines for empirical treatment of infections. The quality of the majority of the formularies, according to the predefined indicators, was poor, with a mean of 145 points out a possible total of 1,000. Conclusion: The evaluation of 73 Belgian hospital formularies showed that their quality varies and should be enhanced in order to serve its target groups better