约旦药店临时配制的流行情况、决定因素和特征。
Prevalence, determinants, and characteristics of extemporaneous compounding in Jordanian pharmacies.
机构信息
Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan.
Wegmans School of Pharmacy, St. John Fisher College, Rochester, NY, USA.
出版信息
BMC Health Serv Res. 2019 Nov 8;19(1):816. doi: 10.1186/s12913-019-4684-y.
BACKGROUND
Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies.
METHODS
This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and verbally responded to the questions.
RESULTS
Results revealed that 223 (51.7%) of the surveyed pharmacies practiced extemporaneous compounding. The main reason for not providing extemporaneous compounding services was lack of prescription orders for compounded preparations (53.8%). The second reason was lack of the equipment and supplies necessary for compounding (24.4%). Extemporaneous compounding prescriptions were mainly issued by dermatologists (98.2%); dermatological indication was the most common of all extemporaneous compounded prescriptions. The main reason for requesting compounded medications was the lack of a commercially available product (87.9%). The vast majority of the compounded dosage forms were creams (99.6) and ointments (91.5), followed by solutions (23.3%). Only 5 (2.2%) of the studied compounding pharmacies prepared sterile products. The major sources for compounding protocols were the physician order (94.2%), and 'in-house' protocols (44.8%). However, the main resource for estimating compounded medications expiration date was information based on pharmacist's experience (57.8%) and the physician's order (53.4%).
CONCLUSIONS
Extemporaneous compounding is a common element of pharmaceutical care. Topical preparations are the most commonly compounded products. Finding from this study suggest that there is a need for standardizing the compounded product formularies, product quality testing, and improving the consistency in estimation of an expiration date of compounded products.
背景
药物配制是药剂实践中的一个重要组成部分，使药剂师能够提供商业上无法获得的剂型或强度。为满足患者特定需求而配制的药物有助于实现个体化医疗。药房提供的临时配制可克服这些治疗产品的市场短缺。本研究的目的是调查和描述约旦药房临时配制的流行情况、特征和决定因素。
方法
本研究基于横断面问卷调查，包括该国 12 个省的 431 家随机选择的药房。通过面对面访谈收集数据，药剂师自愿并口头回答问题。
结果
结果显示，接受调查的药房中有 223 家（51.7%）进行了临时配制。不提供临时配制服务的主要原因是缺乏配制制剂的处方（53.8%）。第二个原因是缺乏配制所需的设备和用品（24.4%）。临时配制处方主要由皮肤科医生开具（98.2%）；皮肤科指征是所有临时配制处方中最常见的。要求配制药物的主要原因是缺乏市售产品（87.9%）。配制的剂型主要是乳膏（99.6%）和软膏（91.5%），其次是溶液（23.3%）。在所研究的配制药房中，只有 5 家（2.2%）制备无菌产品。配制方案的主要来源是医生的医嘱（94.2%）和“内部”方案（44.8%）。然而，估计配制药物有效期的主要依据是基于药剂师经验的信息（57.8%）和医生的医嘱（53.4%）。
结论
临时配制是药物治疗的常见组成部分。局部制剂是最常配制的产品。本研究结果表明，需要标准化配制产品配方、产品质量检测，并提高配制产品有效期的一致性。
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