Tuesday, January 14, 2014

Drug shortages cause for concern

What is the frequency of prescription drug shortages, and what are the adverse patient outcomes related to shortages? Researchers in the service of the pharmaceutical industry took a look recently and found that almost half of pharmacy managers reported experiencing shortages. And the results ranged from inconvenience to death.

Researchers from Northwestern Medicine partnered with MedAssets, as part of the MedAssets Pharmacy Coalition. Almost 200 pharmacy managers responded to a questionnaire that asked them about drug shortages related patient complaints, adverse events, medication errors, patient outcomes, demographics and institutional costs. “Effects on Patient Care Caused by Drug Shortages: A Survey” was published in the November/December issue of the Journal of Managed Care Pharmacy (JMCP).

In general, everyone surveyed said they’d experienced “adverse events” related to drug shortages. Nearly four in 10 said they’d gotten complaints from customers related to drug shortages, and most said shortages were costing them money and even forcing some to dedicate an employee to manage the ramifications of drug shortages to their pharmacy business.

Researchers said drug shortages “have been known to cause, or contribute to, a variety of issues,” including:

Medication errors (such as wrong dose, wrong drug, wrong frequency),
Increased institutional costs
Cancelled care
Delayed treatment
“In addition to the more well-known impacts, the … article revealed that nearly 10 percent of the reported adverse patient outcomes were increased readmissions due to drug shortage related treatment failures,” the researchers reported, shedding some light on the increasing readmission rates being reported nationwide.

Here are some highlights of the survey:

Four in 10 respondents reported “between one and five adverse events probably or possibly associated with drug shortages at their institution.” The majority reported between one and 10 medication errors.

The most common types of medication errors reported were omission (55.5 percent), wrong dose dispensed/administered (54.8 percent), and wrong drug dispensed/administered (34.8 percent).
The most common outcomes reported by respondents were alternative medication used (85.3 percent), delay of therapy (70.8 percent), and increased patient monitoring necessary (49.1 percent).
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.

“Medication errors and adverse events continue to occur from drug shortages, often resulting in inadequate patient care, high institutional costs, and patient complaints,” researchers said. “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.”

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