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General and Risk Management, Patient Safety (including: medication errors, quality control)
Analysis of drug shortages in a hospital pharmacy
  1. J. Dragic
  1. 1Institute for Mother and Child Health Care'Dr Vukan Cupic', Hospital pharmacy, Belgrade, Serbia

Abstract

Background Drug shortages are very frequent in recent years. Hospital pharmacy staff lost many hours on research about reasons for shortages or how to purchase drugs from another wholesaler or find therapeutic alternative to avoid consequences for patients.

Purpose To present drug shortages because it is increasing problem which can compromise patient care.

Materials and methods Summary of drug product shortages in period January 2008–August 2011 in which the authors have been collecting data about shortages. The authors define drug shortage as every delay in monthly drug supply. For this presentation medications which were in shortage less then one month and drug which are not registered in Serbia were omitted.

Results Number of drug in shortages were 17, 18, 26 and 42 from January 2008 to August 2011. Unresolved drug shortages were 12, 9, 10, 14 in that period. Therapeutic groups which were mostly involved in drug shortages were antibiotics and cytotoxic drugs. Patients most affected are from haemato-oncology units and ICU. Reasons for shortages were manufacturing and importation problems, but in most cases The authors did not know details about reasons or expected termination of shortages. As number of shortages is increasing, it is more difficult to find alternative drugs. Number of drugs which had alternative were in percents: 100, 83, 77, 74% from 2008 to 2011. Use of alternative drugs resulted in changes in therapeutic plans and higher costs but without adverse outcomes for patients. Consequences of drug shortages without alternative were delays of therapy. Drugs without alternative were most often cytotoxic drugs. Number of injectable drugs in shortages is increasing and were 6, 8, 15, 17, and it is very troublesome because it is more difficult to find alternative intravenous medication than drug for another routes.

Conclusions Drug shortages is huge and increasing problem. Number of drugs shortages is in increase and in 2011 is twice higher than in 2008. Hospital pharmacist is in position to first know about shortages and to start many actions to diminish damages of patients. Most of interventions were suggestions of similar drugs. Drug shortage is opportunity for hospital pharmacist to be more involved in patient care and hospital drug management.

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