Assessment of Hospital Formulary Compliance among Prescribers at a Federal Medical Centre in Katsina State, North West Nigeria

Background: Hospital formularies are essential tools for promoting rational drug use, cost containment, and medication safety. Prescriber compliance with the hospital formulary is a fundamental indicator of institutional medicine governance. This study assessed formulary compliance among prescribers at Federal Medical Centre Katsina, North West Nigeria. Methods: A retrospective cross-sectional review of 600 outpatient and inpatient prescriptions from five clinical departments was conducted. Prescriptions were assessed for concordance with the hospital formulary, documentation of justification for non-formulary drug use, and department-level variation in compliance rates. A complementary survey of 50 prescribers assessed awareness of and attitudes towards the formulary. Results: Overall formulary compliance was 71 percent across all prescriptions. Non-formulary prescribing was highest in the surgical (38%) and orthopaedic (34%) departments. Justification for non-formulary use was documented in only 22 percent of non-compliant prescriptions. Prescriber awareness of formulary update procedures was low (29%). Conclusion: Formulary compliance at FMC Katsina requires improvement, particularly in surgical-related departments. Regular prescriber orientation on formulary updates, clearer non-formulary exception pathways, and drug and therapeutics committee engagement are essential. Keywords: hospital formulary, prescriber compliance, Katsina, drug and therapeutics committee, rational prescribing