Effects on Patient Care Caused by Drug Shortages: A Survey

Abstract

BACKGROUND: Drug shortages pose a serious challenge for health care institutions, often interfering with patient care. A common practice during a drug shortage is to select an alternate therapeutic; however, these agents often present challenges and may create safety concerns. Patient harms including adverse events and medication errors may occur. Patients may also file complaints because of drug shortages. OBJECTIVE: To measure the effect of drug shortages on patient outcomes, clinical pharmacy operations, patient complaints, and institutional cost.METHODS: An e-mail link to an online survey was sent to pharmacy director members in the MedAssets Pharmacy Group Purchasing Organization. Data were collected within a 3-week period from October 2-23, 2012. The survey focused on 6 different domains: demographics, adverse events, medication errors, patient outcomes, patient complaints, and institutional cost. RESULTS:The survey was sent to 1,516 directors of pharmacy. There were 193 respondents (response rate 13%) who participated in the survey. Approximately 40% of respondents reported between 1 and 5 adverse events probably or possibly associated with drug shortages at their institution. The majority of respondents reported between 1 and 10 medication errors. The most common types of medication errors reported were omission (n = 86, 55.5%), wrong dose dispensed/administered (n = 85, 54.8%), and wrong drug dispensed/administered (n = 54, 34.8%). The most common outcomes reported by respondents were alternative medication used (n=146, 85.3%), delay of therapy (n = 121, 70.8%), and increased patient monitoring necessary (n = 84, 49.1%). Patient complaints were reported by 38% of respondents. The majority of respondents reported an estimated quarterly institutional cost from shortages of less than $100,000, and approximately one quarter of respondents reported adding at least 1 full-time equivalent to manage drug shortages. The majority of participant comments mentioned the increasing institutional costs attributed to drug shortages.CONCLUSIONS: Medication errors and adverse events continue to occur from drug shortages, often resulting in inadequate patient care, high institutional costs, and patient complaints. Delayed care and cancelled care have been reported from shortages. Further research is necessary to better classify medication errors and adverse events during a drug shortage.

Impact of Drug Shortages on Health System Pharmacies in the Southeastern United States

“…Our survey findings regarding FTE results are similar to those found in other surveys. 31 Several examples of our systematic process and action steps to addresses drug shortages are included in Table 1.…”

Nutrition and Dietetic Product Shortages are A Neglected Issue in Alerting Systems and in Registries

“…Medicines shortages (also referred to as drug shortages) are a challenging global phenomenon affecting all hospital and health systems [1][2][3][4][5]. Furthermore it is a phenomenon that if left alone threatens to become a crisis in terms of delivering patient care [6,7].…”

“…Not only, but mainly in oncology, specific products are needed for on-going multicycle therapies according to international protocols. Disruption and switch to an alternative is rarely feasible and com-promises seriously patient safety and clinical outcome [1,8,9].…”

Impact of an Intravenous Trimethoprim/Sulfamethoxazole Shortage on Treatment Outcomes Among HIV-Infected Patients with Pneumocystis jirovecii Pneumonia

“…22 Drug shortages have become common among many classes of medication, but the number of antimicrobials impacted by drug shortages poses a serious problem for the provision of anti-infective therapy in the United States. 23,24 A recent survey of pharmacy directors by McLaughlin et al (2013) sought to measure the impact of drug shortages on patient outcomes, clinical pharmacy operations, patient complaints, and institutional cost. 25 The authors found that 85.3% of respondents reported the use of alternative medications; 70.8% reported delays in medication therapy; and almost 50% reported a need for increased patient monitoring.…”