Article Text
Abstract
Background and importance The incidence of medicine shortages (MS) has increased in the past few years, causing difficulties for clinicians, patients and regulators. MS can occur for many reasons, including manufacturing and quality problems, regulatory issues and business decisions. The role of the pharmacist is essential in their management.
Aim and objectives To analyse the MS that have affected the outpatient clinic (OC) between January 2018 and September 2019, and to evaluate their economic impact and effect on the daily work of a hospital pharmacist in a general hospital (280 beds).
Material and methods A descriptive, observational and retrospective study was carried out analysing data between January 2018 and September 2019. Data were retrieved from official notifications received by email, the Spanish Medicines Agency (AEMPS) online platform and the Farmatools programme. Variables collected were: drugs with shortage problems, medicines available through the application for management of medicines in special situations (AGMSE) of the AEMPS, MS emails received, orders of foreign medicines and dispensations and time dedicated to managing MS.
Results During the study period, 1162 emails about MS were received and revised (average 55 per month). Forty-seven drugs with shortage problems were available through AGMSE as foreign medicines and 39 of them (83%), corresponding to 31 active substances, were managed from the OC: 92.3% of drugs imported, 2.5% performed as magistral preparations and 5.1% dispensed from inpatient stock. A total of 122 medicine orders were done, 6 per month, resulting in a total cost increase of 7643.73€.
According to Spanish law, foreign medicines must be provided by hospital pharmacies; therefore, 280 new outpatients who usually collect their medication at the community pharmacy attended the OC (a total of 739 dispensations, 35.19 per month).
The average time devoted to shortages in the OC was 10.13 hours per month, 5.15 hours for dispensation and pharmaceutical care activity and 4.85 hours for executing orders, and reception and administrative tasks.
Conclusion and relevance MS are time consuming and imply a significant increase in the hospital pharmacist’s activity, mainly focused on administrative responsibilities, adding new drugs in formulary and planning for strategies to maintain the medication supply. Furthermore, this problem implies a higher number of patients attending the OC to collect their medication.
References and/or acknowledgements No conflict of interest.