As part of a view of hospital practice a sample of medical records of 15 intensive care units were analysed for the following items: reason for and origin of admission, age, sex, full pharmacological history, length of stay, clinical outcome, discharge diagnosis. Antibiotic therapy, steroid use for shock, problems of hemostasis, and cardiovascular drugs are areas where an active intervention appears to be specifically needed. Interhospital differences in diagnostic and general care criteria, documentation of inappropriate therapeutic practice, lack of reliable data registration gave occasion for an extensive discussion with clinicians leading to decisions on exclusion of drugs from hospital formularies, organization of information programs and of controlled clinical trials. The application of simple techniques of drug utilization review has proved a useful, inexpensive tool for creating favourable conditions for wide scale improvement of therapeutic practice.
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