PHARMACY RESEARCH Drug shortages at hospitals affect patient care, poll finds

The lack of drugs puts patients at risk, pharmacy researchers said.
SCRIPPS HOWARD
Drug shortages are forcing hospitals to cancel or delay procedures and keep patients longer, according a national survey of pharmacists.
The survey of nearly 500 acute-care hospital pharmacy managers around the country last year found 95 percent said that shortages of drugs forced them to change the way care is delivered.
Sixty-five percent reported that at least one procedure had to be canceled or delayed because of the lack of one of nine drug products in short supply nationwide.
Will be published
The results of the online survey are being published in the Friday issue of the American Journal of Health-System Pharmacy and are considered the first formal effort to gauge the effects of drug shortages on patient care in hospitals.
"Patients are at risk when a needed drug is not available or when health-care providers must work with substitute medications," said Henri Manasse, executive vice president of the American Society of Health-System Pharmacists, which did the survey along with researchers at Johns Hopkins Hospital in Baltimore.
Although 29 percent of the pharmacy directors said there had been no adverse outcomes to patients, 31 percent said patients had to stay in the hospital longer because of the lack of a particular drug. Ten percent said there had been a serious medication error related to the supply problem, and 1 percent said a patient died or suffered loss of function.
Shortages also affected drug prices, as pharmacists are forced to buy the same product at higher prices than the contract from a regular supplier calls for, or to buy more expensive products in the same therapeutic class as a substitute.
Time consuming
The survey found that pharmacists are spending more time managing the shortages, often hiring more staff just to track product availability, identify and buy alternatives or to compound their own substitute medicines in-house. They're also spending more time explaining the alternative drugs to doctors and nurses.
"Because of shortages, pharmacists must select and purchase substitute products as well as determine proper dosing, modify drug-use policies and procedures, educate various health-care personnel and restock supplies through the facility," said David Witmer, a pharmacist and vice president of the society who co-authored the report. "All of these extra steps increase risks and add unnecessary costs to the health system."
Based on what pharmacists reported their departments were spending just on buying drugs outside the normal supply chain (not counting personnel costs), the researchers estimate that drug shortages add nearly $100 million annually in unexpected costs to the country's health-care system. The society works with members who practice in hospitals and health systems to improve medication use and safety and has established an online center that tracks drug shortages and helps pharmacists find alternatives.