Rider Anne Elise, Templet Derek J, Daley Mitchell J, Shuman Carrie, Smith Leticia V
Seton Medical Center Austin, Austin, TX, USA.
J Pharm Pract. 2013 Jun;26(3):183-91. doi: 10.1177/0897190013482332. Epub 2013 Apr 3.
The objectives of this article are to review the clinical implications of drug shortages highlighting patient safety, sedation, and oncology and introduce an expanded phase approach for the management of drug shortages.
Literature retrieval was accessed through a PubMed search of English-language sources from January 1990 through April 2012 using the medical subject heading pharmaceutical preparations/supply and distribution and the general search term drug shortages.
All original prospective and retrospective studies, peer-reviewed guidelines, consensus statements, and review articles were evaluated for inclusion. Relevance was determined considering the therapeutic class, focus on drug shortages, and manuscript type.
The increased number of drug shortages has created significant challenges for health care providers. Two particularly vulnerable populations are critically ill and oncology patients. A lack of therapeutic alternatives in critically ill patients may impact patient safety as well as treatment outcomes. Similarly, a chemotherapy agent in short supply may contribute to adverse outcomes in oncology patients.
The mounting number of drug shortages has created a health care crisis, requiring changes in management strategies as well as clinical practice. The expanded phased approach outlined here provides a consistent, systematic approach for the management of drug shortages.
本文的目的是回顾药物短缺在患者安全、镇静及肿瘤学方面的临床影响，并介绍一种用于药物短缺管理的扩展阶段方法。
通过PubMed检索1990年1月至2012年4月的英文文献，使用医学主题词“药物制剂/供应与分配”以及通用检索词“药物短缺”。
对所有原创前瞻性和回顾性研究、同行评审指南、共识声明及综述文章进行纳入评估。根据治疗类别、对药物短缺的关注以及稿件类型确定相关性。
药物短缺数量的增加给医疗服务提供者带来了重大挑战。两个特别脆弱的人群是重症患者和肿瘤患者。重症患者缺乏治疗替代方案可能会影响患者安全以及治疗结果。同样，供应短缺的化疗药物可能会导致肿瘤患者出现不良后果。
药物短缺数量的不断增加引发了医疗危机，需要改变管理策略以及临床实践。本文概述的扩展阶段方法为药物短缺管理提供了一种一致、系统的方法。
