Two-thirds of pharmacists believe in disclosing source of high-risk compounded sterile preparations to prescribers

A majority of pharmacists and other healthcare practitioners believe that pharmacists need to disclose the source of high-risk compounded sterile preparations (CSPs) to prescribers, according to a recent survey.

The Institute for Safe Medication Practices (ISMP) surveyed 412 practitioners-mostly pharmacists-late last year to find out how hospitals are managing the preparation and purchase of high-risk CSPs. High-risk CSPs have been in the spotlight since the national outbreak of fungal meningitis from contaminated steroid injections last year. 

“The deadly outbreak also served as a wake-up call to all healthcare providers who compound sterile medications in any setting to examine their own compounding procedures and to assess the training provided to those who prepare CSPs,” according to a statement from ISMP.

ISMP found that 67% of practitioners believe that disclosing the source of high-risk CSPs to prescribers is warranted. When the high-risk CSP has been prepared by an external compounding pharmacy, 75% believe that the source should be disclosed, while only 60% said it should be disclose if it was prepared by the hospital pharmacy.

Practitioners who believe that disclosure to the prescriber was necessary said the disclosure helps the prescriber understand that the preparations are “high-risk”, similar to when prescribers are notified about “high-alert” medications. “In the face of a drug shortage or product unavailability, numerous respondents told us that prescribers are not always aware that the products prescribed require sterile compounding from non-sterile ingredients and may consider other options if they were aware of the risks,” ISMP stated.

Twenty-three percent of practitioners did not believe disclosure to prescribers was necessarily, probably because they believe the pharmacy is responsible for the dispensed high-risk CSP, according to ISMP. “Some felt that required disclosure was akin to pharmacy ‘passing the buck’ of responsibility on to the prescriber,” ISMP stated in the report.

In addition, 54% of practitioners do not think prescribers need to disclose the source of high-risk CSPs to patients. However, 59% said that disclosure to patients was warranted when the CSPs were prepared by an external compounding pharmacy, compared to when it was prepared by the hospital pharmacy (48%).