Q J Med 2002; 95: 181-184
© 2002 Association of Physicians
Commentary |
Medicines management: a sour taste
From the West Midlands Centre for Adverse Drug Reaction Reporting, City Hospital, Birmingham, UK
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Introduction |
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‘Medicines management in hospitals encompasses the entire way that medicines are selected, procured, delivered, prescribed, administered, and reviewed ...’1 states the Audit Commission in its recent report, A spoonful of sugar, which views matters almost entirely from the perspective of clinical pharmacists. We can agree with the Commission that medicines are becoming more expensive, that some hospitals seem to be spendthrift and others parsimonious with drugs, and that drug budgets should, and will, span primary and hospital care. We can also agree that medication errors are unacceptably common, since any error is one too many. Many of the Commission's conclusions, though, seem insecure.
The selection of drugs through hospital formularies is crucial to safe, effective, and economic prescribing. A choice needs to be made, for example, among the 11 angiotensin-converting enzyme inhibitors, or several of the 25 non-steroidal anti-inflammatory drugs, where differences are small. The Commission emphasizes the need
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