Background The experienced increase of drug shortages (DS) in recent years has obliged pharmacists to monitor the actual market situation. This is significant since there is currently no reliable central database in Germany which lists DS in time. The kind of DS in the hospital setting demands a rapid and focused management in order to ensure continuity of care.
Purpose Our aim was to develop a method to provide internal transparency over DS affecting our clinic (a 1600-bed maximum acute care facility), to cooperate with the physicians for a proper and efficient decision flow, and to adapt correspondingly to the drug-supply chain (DSC).
Material and methods We created a colour-coded algorithm on how to react to DS, depending on certain factors:
Yellow/orange: Therapeutic alternative is available. Consider brief information for the affected units.
Red: Therapeutic alternative is available but with relevant changes (e.g. import, internal compounding in the pharmacy), there is a very limited supply or no drug left at all. Consider interprofessional consultation.
The information was handed out by our drug information department via a drug-information sheet.
The data was recorded in an EXCEL sheet and updated upon each report from the manufacturers. Moreover, relevant changes had to be made depending on the classification of the DS (e.g. master-data-management, ward-order-system, Kanban-system, handling instructions) in order to ensure the DSC.
Results Between 1 January 2018 and 30 June 2018, 273 DS were recorded. Existing DS from 2016/2017 (38) were also included. One-hundred and seventy were resolved by 1 July 2018. Sixty-two were classified as red (critical or threatening to patient safety), 22 of which led to an interprofessional consultation. There was no alternative at all for five DS. Each consultation lasted 1 hour on average. Twenty-two of the recorded DS did not affect our clinic due to length and sufficient stock.
Conclusion The situation in everyday practice is so complex that standard procedures and interdisciplinary communication paths are necessary to manage DS in a way that does not impact the quality and continuity of patient care. Therefore, restrictions on therapeutic alternatives need to be determined and the close collaboration among pharmacists, nurses and physician is inevitable.
References and/or acknowledgements No references.
No conflict of interest.
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