The influence of the Pharmacy Information System and Pharmacy and Therapeutics Committee on physician prescribing behavior in the Saudi Ministry of Health: A descriptive cross-sectional comparison study

The Saudi Ministry of Health (MOH) provides a comprehensive pharmacy benefit program to its beneficiaries. Theoretically, a well developed Pharmacy and Therapeutics (P&T) Committee and Pharmacy Information System (PIS) are essential for the formulary system to be effective; both have potential to influence the physicians' prescribing behaviors such as formulary adherence and patients' outcomes such as access to and utilization of prescription drugs. The research was conducted in two phases to examine this potential. A cross-sectional descriptive survey design was used in the first phase. The survey gathered information about the characteristics of the hospital, pharmacy, PIS and P&T Committee in non-specialized MOH hospitals. Of 127 MOH hospitals included in the first phase, 86 (67.7%) hospitals responded and data for 81 (63.7%) hospitals were valid for analysis. The levels of PIS in those hospitals were still undeveloped in 70 (86.4%) of the MOH respondent hospitals. Only five hospitals used computerized PIS for outpatient pharmacy and only two of these hospitals had potential to have a developed PIS. The adoption of the P&T committee in MOH hospitals was a common practice. Of 81 hospitals, 71 (87.7%) hospitals had P&T Committees.;In the second phase, 20 hospitals were selected for a prescription audit based on PIS and P&T Committee development levels. From each hospital, 150 patient records from the outpatient pharmacy were systematically sampled; data for one hospital were excluded because the prescriptions were not systematically sampled. Dependent variables derived from the auditing stage included the prescribers' formulary adherence and patient's access to and utilization of prescription drugs. A total of 6,885 prescription drugs were prescribed for 2,850 patients in the 19 audited hospitals. The overall rates for formulary adherence and access and utilization were 99.4%, 97.3%, and 2.41 prescriptions per patient, respectively. Tests of associations between the levels of development of PIS and P&T Committee and prescriber's adherence, patient's access to and utilization of prescription drugs were not conclusive. However, the finding might be due to lack of enough data and control of other confounding variables rather than inexistence of associations.