Drug shortages have big impact on 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 resulting from drug shortages - including patient deaths.

The survey was conducted by Northwestern Medicine researchers, in partnership with MedAssets as part of the MedAssets Pharmacy Coalition, an effort 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).

Findings

“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,” said 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 that also addresses the significance of adverse events relating to patient outcomes, said 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 said. “We also saw respondents report very troubling adverse outcomes associated with shortages, including patient deaths. Of the respondents, 2 pharmacy directors reported patient deaths associated with drug shortages, 3 reported disabling adverse events, and 34 reported adverse events that required intervention.

Readmissions and ACA

In addition to the better-known impacts, the study showed that nearly 10% of the reported adverse patient outcomes were increased readmissions resulting from drug-shortage-related treatment failures. Thirty-eight percent of the pharmacy directors surveyed also said their organization had received at least 1 patient complaint related to shortages; of respondents reporting the actual number of patient complaints, approximately 20% reported a total of more than 10 complaints.

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

“Drug shortages are not going away,” Dr Kotis continued. “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 that increased resources were used to manage the shortage problem.”

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 1 full-time-equivalent staff member to manage the drug shortages.