title: [Therapeutic interchange of drugs not included in the hospitaĺs pharmacotherapeutic guide: a quality program].
abstract: 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.
authors.affiliation: Servicio de Farmacia, Hospital Universitario La Fe, Valencia. navarro_sanlar@gva.es
authors.forename: S
authors.initials: S
authors.lastname: Navarro de Lara
authors.forename: I
authors.initials: I
authors.lastname: Font Noguera
authors.forename: V
authors.initials: V
authors.lastname: Lerma Gaude
authors.forename: E
authors.initials: E
authors.lastname: López Briz
authors.forename: M J
authors.initials: MJ
authors.lastname: Martínez Pascual
authors.forename: J L
authors.initials: JL
authors.lastname: Poveda Andrés
mesh_terms: 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
chemical_list: D016568:Drugs, Generic
vernacular_title: Programa de calidad aplicado a la sustitución de medicamentos no incluidos en la Guía Farmacoterapéutica del hospital.