Research Article: The impacts of medication shortages on patient outcomes: A scoping review

Date Published: May 3, 2019

Publisher: Public Library of Science

Author(s): Jonathan Minh Phuong, Jonathan Penm, Betty Chaar, Lachlan Daniel Oldfield, Rebekah Moles, Nienke van Rein.

http://doi.org/10.1371/journal.pone.0215837

Abstract

In recent years, medication shortages have become a growing worldwide issue. This scoping review aimed to systematically synthesise the literature to report on the economic, clinical, and humanistic impacts of medication shortages on patient outcomes.

Medline, Embase, Global Health, PsycINFO and International Pharmaceutical Abstracts were searched using the two key concepts of medicine shortage and patient outcomes. Articles were limited to the English language, human studies and there were no limits to the year of publication. Manuscripts included contained information regarding the shortage of a scheduled medication and had gathered data regarding the economic, clinical, and/or humanistic outcomes of drug shortages on human patients.

We found that drug shortages were predominantly reported to have adverse economic, clinical and humanistic outcomes to patients. Patients were more commonly reported to have increased out of pocket costs, rates of drug errors, adverse events, mortality, and complaints during times of shortage. There were also reports of equivalent and improved patient outcomes in some cases.

The results of this review provide valuable insights into the impact drug shortages have on patient outcomes. The majority of studies reported medication shortages resulted in negative patient clinical, economic and humanistic outcomes.

Partial Text

Medicines are an essential part of medical care, which improve patients’ health and quality of life [1]. In the modern era, with the advancement of manufacturing, distribution, and transport technologies, one would expect medication shortages to be a minor issue, where supply is quickly resolved without negative ramifications to patient health and quality of life. Unfortunately, this is not the case. Medication shortages have been described as a growing worldwide issue in recent years [2].

A total of 230 unique articles were found after the initial search. After application of inclusion and exclusion criteria, 40 manuscripts were included in the final review (Fig 1). These 40 studies all contained data regarding economic, clinical, and/or humanistic impacts of drug shortages on patients.

The results of this review demonstrate that medication shortages are a complex, global phenomenon, which affects patients’ economic, clinical, and humanistic outcomes. While drug shortages have been reported to be a global issue which are reported by 99% of pharmacists each year [19], there were only 40 studies gained from our comprehensive search strategy which reported patient outcomes that met inclusion criteria for review. The reasons for such underreporting may be due to the problem being so ubiquitous that no one has ever really questioned it, or that drug shortages are a new phenomenon which has not yet been fully explored, or that clinician time is spent dealing with workarounds, and time for research, audits, documentation and follow-up is not available. Even though research evidence of patient consequence may be an underreported phenomenon, this review highlighted that regardless of the medicine that was in short supply, the majority of patient outcomes resulting from the shortage were disadvantageous to patients’ clinical, economic and humanistic outcomes.

The results of this review provide valuable insights into the impact drug shortages have on patient outcomes. The majority of studies reported medication shortages resulted in negative patient clinical, economic and humanistic outcomes.

 

Source:

http://doi.org/10.1371/journal.pone.0215837

 

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