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With regard to the latter both formulary restrictions and the heightened professional orientation of hospital-affiliated doctors played a role in the adoption process, with formulary restrictions slightly more so, at least in Northern America.
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These latter factors may be particularly important, considering that the largest improvement in the proportion of subjects with adequate blood pressure control occurred between 2006 and 2007 following the implementation of both Medicare Part D insurance and WalMart's reduced-cost formulary, both in 2006.
Both hospitals made formulary changes from levofloxacin to gatifloxacin; however, the increase in C. difficile infection rates preceded the formulary change in each hospital.
This programme allowed opportunities for prescribers to voice their concerns about vulnerabilities in the prescribing process, resulting in changes to both the online formulary and computerised prescribing process.
Antibiotic safety is an important component of both patient care and formulary decision making.
With the exception of Germany, nearly all hospitals had both a DTC and a formulary.
Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9[955% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90).
Studies by McDonough et al [ 52] and Andrade et al [ 53] both evaluated the impact of formulary switches between agents in the same therapeutic class and found increases in the prescribing of the preferred agents (lisinopril and esterified estrogen tablets, respectively).
Overall, an antibiotic formulary is present in both types of hospitals.
Therefore, our findings suggest that a stewardship program that includes both elimination of unnecessary therapy and formulary substitution when effective alternatives are available could eliminate up to 75% of days of fluoroquinolone therapy without adversely affecting care of patients.
Advocates for Medicaid recipients and the drug industry both expressed concern about the Florida program, saying the formulary could deprive patients of some drugs they need.
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