RT Journal Article
T1 Impact of removal and restriction of me-too medicines in a hospital drug formulary on in- and outpatient drug prescriptions: interrupted time series design with comparison group
A1 Vázquez Mourelle, Raquel
A1 Carracedo Martínez, Eduardo
A1 Figueiras Guzmán, Adolfo
K1 Hospital formulary
K1 Low molecular weight heparin
K1 LMWH
K1 Programme efficiency
K1 Pharmacy and therapeutics committee
K1 Prescription drugs
K1 Cardiovascular drugs
AB Background: The study covered in- and out-of-hospital care in a region in north-western Spain. The interventionevaluated took the form of a change in the hospital drugs formulary. Before the intervention, the formulary containedfour of the five low molecular weight heparins (LMWHs) marketed in Spain. The intervention consisted of withdrawingtwo LMWHs (bemiparin and dalteparin) from the formulary and restricting the use of another (tinzaparin), leaving onlyenoxaparin as an unrestricted prescription LMWH.Accordingly, the aim of this study was to evaluate the effect on in- and outpatient drug prescriptions of removing andrestricting the use of several LMWHs in a hospital drugs formulary.Methods: We used a natural, before-after, quasi-experimental design with a control group and monthly datafrom January 2011 to December 2016. Based on data drawn from official Public Health Service sources, thefollowing dependent variables were extracted: defined daily doses (DDD) per 1000 inhabitants per day(DDD/TID), DDD per 100 stays per day, and expenditure per DDD.Results: The two compounds that were removed from the formulary registered an immediate decrease atboth an intra- and out-of-hospital level (66.6% and 55.6% for bemiparin and 73.0% and 92.2% for dalteparin,respectively); similarly, the compound that was restricted also registered an immediate decrease (36.1% and9.0% at the in- and outpatient levels, respectively); in contrast, the remaining LMWH (enoxaparin) registeredan immediate, significant increase at both levels (44.9% and 32.6%, respectively). The intervention led to animmediate reduction of 6.8% and a change in trend in out-of-hospital cost/DDD; it also avoided anexpenditure of €477,317.1 in the 21 months following the intervention.Conclusions: The results indicate that changes made in a hospital drugs formulary towards more efficientmedications may lead to better use of pharmacotherapeutic resources in its health catchment area.
PB BMC
YR 2019
FD 2019
LK http://hdl.handle.net/10347/21443
UL http://hdl.handle.net/10347/21443
LA eng
NO Vázquez-Mourelle, R., Carracedo-Martínez, E. & Figueiras, A. Impact of removal and restriction of me-too medicines in a hospital drug formulary on in- and outpatient drug prescriptions: interrupted time series design with comparison group. Implementation Sci 14, 75 (2019)
DS Minerva
RD 27 abr 2026