[Therapeutic interchange of drugs not included in the hospitaĺs pharmacotherapeutic guide: a quality program].
BACKGROUND
Standardised substitution of those drugs not included in the hospitaĺs formulary constitutes one of several methods used to improve therapeutic efficiency, due to reduction of variability in pharmaceutical practice and prevention of potential medication errors.


OBJECTIVE
To evaluate quality of drug substitution procedures in those drugs not included in the hospital's formulary.


METHODS
Assessment study in a surgical hospital with 314 beds, using structural, process and outcome criteria from 1998 to 2002.


RESULTS
Compliance degree for structure, process and outcome criteria were 100, 89 and 35%, respectively, while the established standards were 100%. Prevalence values for patients with substituted medication, increased from 2.9 (95%CI, 2.4-3.6) in 1998 to 11.1% (95%CI, 10.2-12.1) in 2002. Non-substituted drugs annual cost decreased from 20,199 in 1998 to 12,356 Euro in 2002. Drug substitution made by the pharmacist had an acceptance degree of 82.5%. No interchange errors were found in 126 replaced drugs.


CONCLUSIONS
The development of quality programs to improve drug prescription adherence to the hospitaĺs formulary, specially those that promote therapeutic interchange under the Pharmacy Committee guidance, are helpful strategies to make a proficient management of patients pharmacotherapy.
Navarro de Lara
S
S
Servicio de Farmacia, Hospital Universitario La Fe, Valencia. navarro_sanlar@gva.es
Font Noguera
I
I
Lerma Gaude
V
V
López Briz
E
E
Martínez Pascual
M J
MJ
Poveda Andrés
J L
JL
D000465:Algorithms; D016568:Drugs, Generic; D005572:Formularies, Hospital as Topic / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010607:Pharmacy Service, Hospital / Q000592:standards*; D010606:Pharmacy and Therapeutics Committee; D011786:Quality Control; D013030:Spain; D013810:Therapeutic Equivalency
D016568:Drugs, Generic
Programa de calidad aplicado a la sustitución de medicamentos no incluidos en la Guía Farmacoterapéutica del hospital.