ISMP Survey on Formulary Myths

Total: 271
1. Please tell us the frequency with which comments were made during formulary deliberations at your 2004 Pharmacy and Therapeutics Committee meetings related to the following categories using the following scale: 1 = Never; 5 = Often.
Also please tell us if the comments (if made) had any impact on the final outcome of a formulary decision. Select NA/? if the category is not applicable (scored as Never) or you are uncertain of the impact of the comments you heard in that category.
Myth Categories (Illustrative Statements Follow Each Category)
Score
Impact
A. Causal Empiricism (anecdotal observations vs. scientific evidence)
(1) I've used this in my private practice for years. (2) We want to try out this drug for 6 to 12 months to get some experience using it and see if we like it.
1 25%
2 21%
3 23%
4 19%
5 12%
No 31%
Yes 69%
B. FDA Approval Implies Everyday Use for All
(1) FDA wouldn't have approved it if it weren't a good drug. (2) Patients should not be denied access to any drug approved by FDA.
1 49%
2 24%
3 13%
4 10%
5 5%
No 54%
Yes 46%
C. Interferes with Clinical Freedom
(1) I'm philosophically opposed to restrictions on doctors' clinical freedoms; we need education instead. (2) Each clinician has his/her own set of drugs that he/she is comfortable with; it's best not to interfere with this with a restricted formulary.
1 33%
2 26%
3 17%
4 12%
5 12%
No 47%
Yes 53%
D. Every Patient is Unique
(1) Every patient is different and we need a variety of drugs to try. (2) We need different drugs to deal with genetic or dietary differences.
1 30%
2 27%
3 21%
4 13%
5 9%
No 44%
Yes 56%
E. The Specialist Knows Best
(1) For this committee to tell infectious disease specialists what antibiotics they should or should not prescribe is highly presumptuous. (2) If cardiology says they need this drug, who are we to question it? (3) The committee is just a bunch of nonsubspecialists making decisions about things they know nothing about.
1 27%
2 20%
3 18%
4 16%
5 19%
No 27%
Yes 73%
F. Education Requires Experience with a Multitude of Drugs
(1) By not having access to the newest drugs, our residents are not learning state-of-the-art medicine. (2) In the real world, for which we are training our residents, they don't have all of these restrictions.
1 63%
2 19%
3 10%
4 5%
5 3%
No 62%
Yes 38%
G. Widespread Use Equals Drug of Choice
(1) This is the most popular agent in this class of drugs; how can we do without it? (2) These drugs are widely used worldwide; they are the drugs of today.
1 28%
2 24%
3 27%
4 13%
5 9%
No 35%
Yes 65%
H. Newer is Better/Newer is Safer
(1) The problem with formularies is that they're almost immediately out-of-date. (2) Any unknown risks are far outweighed by the benefits of this new drug.(3) This newer drug clearly has a better side effect profile than the older drug.
1 34%
2 30%
3 19%
4 11%
5 7%
No 47%
Yes 53%
I. Sicker Patients Need More Drugs
(1) We need the drug for patients for whom nothing else has worked and for whom we have no other choices. (2) If you were in my shoes and a sick patient wasn't responding to a first line drug after 24 hours, you'd want other alternatives to try.
1 26%
2 31%
3 17%
4 12%
5 13%
No 33%
Yes 67%
J. Formulary Sacrifices Patient Care to Cost Control
(1) While we probably have to accept drug restrictions due to cost, there is a trade-off in quality each time we do so.
1 38%
2 29%
3 18%
4 9%
5 6%
No 62%
Yes 38%
K. Redundant with Drug Utilization Program (DUR) Program
(1) The formulary can be eliminated if a comprehensive DUR program is operative
1 81%
2 11%
3 5%
4 1%
5 2%
No 62%
Yes 38%


Total for Teaching Hospital: 94
1. Please tell us the frequency with which comments were made during formulary deliberations at your 2004 Pharmacy and Therapeutics Committee meetings related to the following categories using the following scale: 1 = Never; 5 = Often.
Also please tell us if the comments (if made) had any impact on the final outcome of a formulary decision. Select NA/? if the category is not applicable (scored as Never) or you are uncertain of the impact of the comments you heard in that category.
Myth Categories (Illustrative Statements Follow Each Category)
Score
Impact
A. Causal Empiricism (anecdotal observations vs. scientific evidence)
(1) I've used this in my private practice for years. (2) We want to try out this drug for 6 to 12 months to get some experience using it and see if we like it.
1 29%
2 20%
3 18%
4 16%
5 16%
No 34%
Yes 66%
B. FDA Approval Implies Everyday Use for All
(1) FDA wouldn't have approved it if it weren't a good drug. (2) Patients should not be denied access to any drug approved by FDA.
1 44%
2 26%
3 17%
4 10%
5 3%
No 57%
Yes 43%
C. Interferes with Clinical Freedom
(1) I'm philosophically opposed to restrictions on doctors' clinical freedoms; we need education instead. (2) Each clinician has his/her own set of drugs that he/she is comfortable with; it's best not to interfere with this with a restricted formulary.
1 34%
2 30%
3 20%
4 9%
5 7%
No 61%
Yes 39%
D. Every Patient is Unique
(1) Every patient is different and we need a variety of drugs to try. (2) We need different drugs to deal with genetic or dietary differences.
1 27%
2 24%
3 23%
4 14%
5 12%
No 39%
Yes 61%
E. The Specialist Knows Best
(1) For this committee to tell infectious disease specialists what antibiotics they should or should not prescribe is highly presumptuous. (2) If cardiology says they need this drug, who are we to question it? (3) The committee is just a bunch of nonsubspecialists making decisions about things they know nothing about.
1 32%
2 20%
3 15%
4 16%
5 17%
No 26%
Yes 74%
F. Education Requires Experience with a Multitude of Drugs
(1) By not having access to the newest drugs, our residents are not learning state-of-the-art medicine. (2) In the real world, for which we are training our residents, they don't have all of these restrictions.
1 49%
2 27%
3 13%
4 9%
5 3%
No 60%
Yes 40%
G. Widespread Use Equals Drug of Choice
(1) This is the most popular agent in this class of drugs; how can we do without it? (2) These drugs are widely used worldwide; they are the drugs of today.
1 23%
2 28%
3 27%
4 13%
5 10%
No 38%
Yes 62%
H. Newer is Better/Newer is Safer
(1) The problem with formularies is that they're almost immediately out-of-date. (2) Any unknown risks are far outweighed by the benefits of this new drug.(3) This newer drug clearly has a better side effect profile than the older drug.
1 37%
2 31%
3 15%
4 13%
5 4%
No 56%
Yes 44%
I. Sicker Patients Need More Drugs
(1) We need the drug for patients for whom nothing else has worked and for whom we have no other choices. (2) If you were in my shoes and a sick patient wasn't responding to a first line drug after 24 hours, you'd want other alternatives to try.
1 25%
2 29%
3 22%
4 11%
5 14%
No 39%
Yes 61%
J. Formulary Sacrifices Patient Care to Cost Control
(1) While we probably have to accept drug restrictions due to cost, there is a trade-off in quality each time we do so.
1 43%
2 28%
3 16%
4 10%
5 3%
No 63%
Yes 37%
K. Redundant with Drug Utilization Program (DUR) Program
(1) The formulary can be eliminated if a comprehensive DUR program is operative
1 79%
2 12%
3 6%
4 1%
5 2%
No 47%
Yes 53%


Total for Non-teaching Hospital: 119
1. Please tell us the frequency with which comments were made during formulary deliberations at your 2004 Pharmacy and Therapeutics Committee meetings related to the following categories using the following scale: 1 = Never; 5 = Often.
Also please tell us if the comments (if made) had any impact on the final outcome of a formulary decision. Select NA/? if the category is not applicable (scored as Never) or you are uncertain of the impact of the comments you heard in that category.
Myth Categories (Illustrative Statements Follow Each Category)
Score
Impact
A. Causal Empiricism (anecdotal observations vs. scientific evidence)
(1) I've used this in my private practice for years. (2) We want to try out this drug for 6 to 12 months to get some experience using it and see if we like it.
1 19%
2 22%
3 29%
4 22%
5 8%
No 28%
Yes 72%
B. FDA Approval Implies Everyday Use for All
(1) FDA wouldn't have approved it if it weren't a good drug. (2) Patients should not be denied access to any drug approved by FDA.
1 55%
2 19%
3 10%
4 10%
5 5%
No 49%
Yes 51%
C. Interferes with Clinical Freedom
(1) I'm philosophically opposed to restrictions on doctors' clinical freedoms; we need education instead. (2) Each clinician has his/her own set of drugs that he/she is comfortable with; it's best not to interfere with this with a restricted formulary.
1 31%
2 23%
3 17%
4 15%
5 14%
No 38%
Yes 62%
D. Every Patient is Unique
(1) Every patient is different and we need a variety of drugs to try. (2) We need different drugs to deal with genetic or dietary differences.
1 32%
2 29%
3 18%
4 13%
5 8%
No 46%
Yes 54%
E. The Specialist Knows Best
(1) For this committee to tell infectious disease specialists what antibiotics they should or should not prescribe is highly presumptuous. (2) If cardiology says they need this drug, who are we to question it? (3) The committee is just a bunch of nonsubspecialists making decisions about things they know nothing about.
1 24%
2 18%
3 22%
4 18%
5 18%
No 23%
Yes 77%
F. Education Requires Experience with a Multitude of Drugs
(1) By not having access to the newest drugs, our residents are not learning state-of-the-art medicine. (2) In the real world, for which we are training our residents, they don't have all of these restrictions.
1 77%
2 13%
3 8%
4 2%
5 1%
No 70%
Yes 30%
G. Widespread Use Equals Drug of Choice
(1) This is the most popular agent in this class of drugs; how can we do without it? (2) These drugs are widely used worldwide; they are the drugs of today.
1 29%
2 24%
3 28%
4 14%
5 6%
No 33%
Yes 67%
H. Newer is Better/Newer is Safer
(1) The problem with formularies is that they're almost immediately out-of-date. (2) Any unknown risks are far outweighed by the benefits of this new drug.(3) This newer drug clearly has a better side effect profile than the older drug.
1 29%
2 32%
3 19%
4 11%
5 9%
No 40%
Yes 60%
I. Sicker Patients Need More Drugs
(1) We need the drug for patients for whom nothing else has worked and for whom we have no other choices. (2) If you were in my shoes and a sick patient wasn't responding to a first line drug after 24 hours, you'd want other alternatives to try.
1 28%
2 32%
3 13%
4 14%
5 13%
No 27%
Yes 73%
J. Formulary Sacrifices Patient Care to Cost Control
(1) While we probably have to accept drug restrictions due to cost, there is a trade-off in quality each time we do so.
1 36%
2 27%
3 21%
4 11%
5 5%
No 62%
Yes 38%
K. Redundant with Drug Utilization Program (DUR) Program
(1) The formulary can be eliminated if a comprehensive DUR program is operative
1 84%
2 10%
3 4%
4 2%
No 80%
Yes 20%


Total for Hospital with less than 100 beds: 64
1. Please tell us the frequency with which comments were made during formulary deliberations at your 2004 Pharmacy and Therapeutics Committee meetings related to the following categories using the following scale: 1 = Never; 5 = Often.
Also please tell us if the comments (if made) had any impact on the final outcome of a formulary decision. Select NA/? if the category is not applicable (scored as Never) or you are uncertain of the impact of the comments you heard in that category.
Myth Categories (Illustrative Statements Follow Each Category)
Score
Impact
A. Causal Empiricism (anecdotal observations vs. scientific evidence)
(1) I've used this in my private practice for years. (2) We want to try out this drug for 6 to 12 months to get some experience using it and see if we like it.
1 31%
2 30%
3 20%
4 13%
5 6%
No 44%
Yes 56%
B. FDA Approval Implies Everyday Use for All
(1) FDA wouldn't have approved it if it weren't a good drug. (2) Patients should not be denied access to any drug approved by FDA.
1 63%
2 14%
3 9%
4 8%
5 6%
No 42%
Yes 58%
C. Interferes with Clinical Freedom
(1) I'm philosophically opposed to restrictions on doctors' clinical freedoms; we need education instead. (2) Each clinician has his/her own set of drugs that he/she is comfortable with; it's best not to interfere with this with a restricted formulary.
1 39%
2 31%
3 9%
4 11%
5 9%
No 51%
Yes 49%
D. Every Patient is Unique
(1) Every patient is different and we need a variety of drugs to try. (2) We need different drugs to deal with genetic or dietary differences.
1 45%
2 20%
3 20%
4 9%
5 5%
No 43%
Yes 57%
E. The Specialist Knows Best
(1) For this committee to tell infectious disease specialists what antibiotics they should or should not prescribe is highly presumptuous. (2) If cardiology says they need this drug, who are we to question it? (3) The committee is just a bunch of nonsubspecialists making decisions about things they know nothing about.
1 31%
2 17%
3 23%
4 16%
5 13%
No 27%
Yes 73%
F. Education Requires Experience with a Multitude of Drugs
(1) By not having access to the newest drugs, our residents are not learning state-of-the-art medicine. (2) In the real world, for which we are training our residents, they don't have all of these restrictions.
1 83%
2 8%
3 5%
4 3%
No 83%
Yes 17%
G. Widespread Use Equals Drug of Choice
(1) This is the most popular agent in this class of drugs; how can we do without it? (2) These drugs are widely used worldwide; they are the drugs of today.
1 34%
2 19%
3 30%
4 11%
5 6%
No 32%
Yes 68%
H. Newer is Better/Newer is Safer
(1) The problem with formularies is that they're almost immediately out-of-date. (2) Any unknown risks are far outweighed by the benefits of this new drug.(3) This newer drug clearly has a better side effect profile than the older drug.
1 41%
2 23%
3 19%
4 8%
5 9%
No 39%
Yes 61%
I. Sicker Patients Need More Drugs
(1) We need the drug for patients for whom nothing else has worked and for whom we have no other choices. (2) If you were in my shoes and a sick patient wasn't responding to a first line drug after 24 hours, you'd want other alternatives to try.
1 39%
2 22%
3 19%
4 8%
5 13%
No 28%
Yes 72%
J. Formulary Sacrifices Patient Care to Cost Control
(1) While we probably have to accept drug restrictions due to cost, there is a trade-off in quality each time we do so.
1 42%
2 28%
3 20%
4 3%
5 6%
No 69%
Yes 31%
K. Redundant with Drug Utilization Program (DUR) Program
(1) The formulary can be eliminated if a comprehensive DUR program is operative
1 84%
2 11%
3 5%
No 88%
Yes 13%


Total for Hospital with 100-300 beds: 98
1. Please tell us the frequency with which comments were made during formulary deliberations at your 2004 Pharmacy and Therapeutics Committee meetings related to the following categories using the following scale: 1 = Never; 5 = Often.
Also please tell us if the comments (if made) had any impact on the final outcome of a formulary decision. Select NA/? if the category is not applicable (scored as Never) or you are uncertain of the impact of the comments you heard in that category.
Myth Categories (Illustrative Statements Follow Each Category)
Score
Impact
A. Causal Empiricism (anecdotal observations vs. scientific evidence)
(1) I've used this in my private practice for years. (2) We want to try out this drug for 6 to 12 months to get some experience using it and see if we like it.
1 22%
2 17%
3 23%
4 25%
5 14%
No 19%
Yes 81%
B. FDA Approval Implies Everyday Use for All
(1) FDA wouldn't have approved it if it weren't a good drug. (2) Patients should not be denied access to any drug approved by FDA.
1 45%
2 25%
3 18%
4 9%
5 3%
No 46%
Yes 54%
C. Interferes with Clinical Freedom
(1) I'm philosophically opposed to restrictions on doctors' clinical freedoms; we need education instead. (2) Each clinician has his/her own set of drugs that he/she is comfortable with; it's best not to interfere with this with a restricted formulary.
1 32%
2 21%
3 19%
4 20%
5 9%
No 37%
Yes 63%
D. Every Patient is Unique
(1) Every patient is different and we need a variety of drugs to try. (2) We need different drugs to deal with genetic or dietary differences.
1 25%
2 32%
3 19%
4 14%
5 10%
No 48%
Yes 52%
E. The Specialist Knows Best
(1) For this committee to tell infectious disease specialists what antibiotics they should or should not prescribe is highly presumptuous. (2) If cardiology says they need this drug, who are we to question it? (3) The committee is just a bunch of nonsubspecialists making decisions about things they know nothing about.
1 23%
2 20%
3 18%
4 18%
5 23%
No 22%
Yes 78%
F. Education Requires Experience with a Multitude of Drugs
(1) By not having access to the newest drugs, our residents are not learning state-of-the-art medicine. (2) In the real world, for which we are training our residents, they don't have all of these restrictions.
1 65%
2 17%
3 10%
4 7%
5 1%
No 52%
Yes 48%
G. Widespread Use Equals Drug of Choice
(1) This is the most popular agent in this class of drugs; how can we do without it? (2) These drugs are widely used worldwide; they are the drugs of today.
1 24%
2 26%
3 25%
4 15%
5 10%
No 30%
Yes 70%
H. Newer is Better/Newer is Safer
(1) The problem with formularies is that they're almost immediately out-of-date. (2) Any unknown risks are far outweighed by the benefits of this new drug.(3) This newer drug clearly has a better side effect profile than the older drug.
1 26%
2 32%
3 23%
4 14%
5 5%
No 41%
Yes 59%
I. Sicker Patients Need More Drugs
(1) We need the drug for patients for whom nothing else has worked and for whom we have no other choices. (2) If you were in my shoes and a sick patient wasn't responding to a first line drug after 24 hours, you'd want other alternatives to try.
1 22%
2 30%
3 17%
4 16%
5 16%
No 33%
Yes 67%
J. Formulary Sacrifices Patient Care to Cost Control
(1) While we probably have to accept drug restrictions due to cost, there is a trade-off in quality each time we do so.
1 26%
2 30%
3 22%
4 16%
5 6%
No 54%
Yes 46%
K. Redundant with Drug Utilization Program (DUR) Program
(1) The formulary can be eliminated if a comprehensive DUR program is operative
1 80%
2 12%
3 6%
4 1%
5 1%
No 53%
Yes 47%


Total for Hospital with more than 300 beds: 75
1. Please tell us the frequency with which comments were made during formulary deliberations at your 2004 Pharmacy and Therapeutics Committee meetings related to the following categories using the following scale: 1 = Never; 5 = Often.
Also please tell us if the comments (if made) had any impact on the final outcome of a formulary decision. Select NA/? if the category is not applicable (scored as Never) or you are uncertain of the impact of the comments you heard in that category.
Myth Categories (Illustrative Statements Follow Each Category)
Score
Impact
A. Causal Empiricism (anecdotal observations vs. scientific evidence)
(1) I've used this in my private practice for years. (2) We want to try out this drug for 6 to 12 months to get some experience using it and see if we like it.
1 20%
2 23%
3 27%
4 18%
5 12%
No 30%
Yes 70%
B. FDA Approval Implies Everyday Use for All
(1) FDA wouldn't have approved it if it weren't a good drug. (2) Patients should not be denied access to any drug approved by FDA.
1 45%
2 29%
3 9%
4 13%
5 3%
No 64%
Yes 36%
C. Interferes with Clinical Freedom
(1) I'm philosophically opposed to restrictions on doctors' clinical freedoms; we need education instead. (2) Each clinician has his/her own set of drugs that he/she is comfortable with; it's best not to interfere with this with a restricted formulary.
1 32%
2 33%
3 17%
4 7%
5 11%
No 57%
Yes 43%
D. Every Patient is Unique
(1) Every patient is different and we need a variety of drugs to try. (2) We need different drugs to deal with genetic or dietary differences.
1 24%
2 29%
3 24%
4 12%
5 11%
No 42%
Yes 58%
E. The Specialist Knows Best
(1) For this committee to tell infectious disease specialists what antibiotics they should or should not prescribe is highly presumptuous. (2) If cardiology says they need this drug, who are we to question it? (3) The committee is just a bunch of nonsubspecialists making decisions about things they know nothing about.
1 24%
2 23%
3 16%
4 17%
5 20%
No 31%
Yes 69%
F. Education Requires Experience with a Multitude of Drugs
(1) By not having access to the newest drugs, our residents are not learning state-of-the-art medicine. (2) In the real world, for which we are training our residents, they don't have all of these restrictions.
1 53%
2 27%
3 12%
4 5%
5 3%
No 66%
Yes 34%
G. Widespread Use Equals Drug of Choice
(1) This is the most popular agent in this class of drugs; how can we do without it? (2) These drugs are widely used worldwide; they are the drugs of today.
1 24%
2 28%
3 24%
4 15%
5 9%
No 38%
Yes 62%
H. Newer is Better/Newer is Safer
(1) The problem with formularies is that they're almost immediately out-of-date. (2) Any unknown risks are far outweighed by the benefits of this new drug.(3) This newer drug clearly has a better side effect profile than the older drug.
1 35%
2 37%
3 13%
4 9%
5 5%
No 61%
Yes 39%
I. Sicker Patients Need More Drugs
(1) We need the drug for patients for whom nothing else has worked and for whom we have no other choices. (2) If you were in my shoes and a sick patient wasn't responding to a first line drug after 24 hours, you'd want other alternatives to try.
1 20%
2 40%
3 15%
4 13%
5 12%
No 32%
Yes 68%
J. Formulary Sacrifices Patient Care to Cost Control
(1) While we probably have to accept drug restrictions due to cost, there is a trade-off in quality each time we do so.
1 49%
2 27%
3 15%
4 7%
5 3%
No 71%
Yes 29%
K. Redundant with Drug Utilization Program (DUR) Program
(1) The formulary can be eliminated if a comprehensive DUR program is operative
1 82%
2 10%
3 3%
4 3%
5 3%
No 50%
Yes 50%

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