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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 • THANK YOU