Drug shortages impact patient care

Drug shortages remain a serious problem for patient safety, according to newly published results from a survey of pharmacy directors. Nearly half of the responding directors reported adverse events at their facilities due to drug shortages, including patient deaths.

The survey was conducted by Northwestern Medicine researchers in partnership with MedAssets, as part of the MedAssets Pharmacy Coalition to better understand how drug shortages affect patient outcomes.
The survey asked pharmacy directors from a variety of healthcare settings to supply information on drug shortage-related patient complaints, adverse events, medication errors, patient outcomes, demographics and institutional costs. The survey’s findings were detailed in “Effects on Patient Care Caused by Drug Shortages: A Survey,” a research article published in the November/December issue of the Journal of Managed Care Pharmacy (JMCP).

“The basic findings of the study are that institutions are still reporting harms due to drug shortages. These harms include poor patient outcomes, medication errors and delayed or cancelled care. Participants also indicated that they are receiving patient complaints due to drug shortages,” says Milena McLaughlin, PharmD, MSc, clinical pharmacist at Northwestern Memorial Hospital, assistant professor at the Midwestern University Chicago College of Pharmacy and lead author of the JMCP article.

This is the first study to date to address patient complaints, as well as the significance of adverse events relating to patient outcomes, according to Despina Kotis, PharmD, director of pharmacy at Northwestern Memorial HealthCare and co-author of the JMCP article. 

“The survey made it clear that patients were aware of drug shortages and that patient complaints were not uncommon as a result,” Dr. Kotis says. “We also saw respondents report very troubling adverse outcomes associated with shortages, including patient deaths.”

Of the respondents, two pharmacy directors reported patient deaths associated with drug shortages, three reported disabling adverse events and 34 reported adverse events that required intervention.

NEXT: Video on drug shortages and patient care >>

Increased readmissions

In addition to the more well-known impacts, the study showed that nearly 10% of the reported adverse patient outcomes were increased readmissions due to drug shortage related treatment failures. Thirty-eight percent of the surveyed pharmacy directors also said their organization had received at least one patient complaint related to shortages, and of those respondents reporting the actual number of patient complaints about 20% reported a total of more than 10 complaints. 

The article’s authors suggest that documented occurrence of increased readmission rates and the impact of drug shortage-related patient complaints could affect healthcare reimbursements for providers in the future as part of the Affordable Care Act.

“Drug shortages are not going away,” Dr. Kotis says. “The survey shows that pharmacy directors still see significant shortages on a day-to-day basis that put patients at risk. Outcomes due to shortages that were commonly reported include patient harm, canceled care, and delayed care. The results also showed increased resources were used to manage the shortage problem.”

Extra staff needed to manage the effects

A majority of respondents estimated that the drug shortages cost their institutions close to $100,000 per quarter. In addition, about one-quarter reported adding one full-time equivalent staff to manage the drug shortages. 

@More: 

Read the February 5, 2014, FDA report that indicates the agency was able to prevent 140 drug shortages here.