Hantel Andrew, Egan Ashley M, Nguyen Trinh T, DeMartino Erin S, Hlubocky Fay, Bastow Samantha, Siegler Mark, Daugherty Christopher K
J Grad Med Educ. 2020 Feb;12(1):38-43. doi: 10.4300/JGME-D-19-00385.1.
Medication shortages prevent patients from receiving optimal care. Despite the frequency with which medical trainees care for inpatients, no assessment of their experiences in medication shortage management has been performed.
We evaluated trainees' experiences managing medication shortages.
We performed a cross-sectional survey of trainees postgraduate year 2 (PGY-2) and above in medicine, anesthesiology, and emergency medicine departments at 2 academic centers in 2018-2019. Categorical and ordinal assessments evaluated shortage awareness, substitution availability, pharmacy and therapeutics committee-based restrictions, communication, and education. Regressions were performed to determine effect of PGY, department, and institution on responses.
A total of 168 of 273 subjects completed the survey (62% response rate). Most (95%, 159 of 168) reported managing medication shortages during training; 51% (86 of 168) described managing clinically relevant shortages daily or weekly. Seventy-seven percent (129 of 168) noted equivalent alternatives were unavailable at least one-quarter of the time, and 43% (72 of 168) reported clinically necessary medications were restricted at least weekly. Fifty-four percent (89 of 168) and 64% (106 of 167) of respondents discussed clinically relevant shortages with supervising physicians or patients "some of the time" or less, respectively. Most respondents (90%, 151 of 168) reported they would benefit from shortage management training, but few (13%, 21 of 168) reported prior training.
Although trainees reported frequent involvement in clinically impactful shortage management, medication shortage communication between trainees and supervising physicians or patients appears sporadic. Medication shortage management training is uncommon but perceived as beneficial.
药品短缺阻碍患者接受最佳治疗。尽管医学实习生经常照顾住院患者，但尚未对他们在药品短缺管理方面的经历进行评估。
我们评估了实习生管理药品短缺的经历。
2018 - 2019年，我们对两所学术中心的医学、麻醉学和急诊科的二年级及以上研究生（PGY - 2及以上）实习生进行了横断面调查。分类和序贯评估涉及短缺意识、替代药品可用性、基于药学与治疗学委员会的限制、沟通和教育。进行回归分析以确定PGY、科室和机构对回答的影响。
273名受试者中有168名完成了调查（回复率62%）。大多数（95%，168名中的159名）报告在培训期间管理过药品短缺；51%（168名中的86名）称每天或每周管理临床相关的短缺情况。77%（168名中的129名）指出至少四分之一的时间没有等效替代药品，43%（168名中的72名）报告临床必需药品至少每周受到限制。分别有54%（168名中的89名）和64%（167名中的106名）的受访者“有时”或更少与指导医师或患者讨论临床相关的短缺情况。大多数受访者（90%，168名中的151名）报告他们将从短缺管理培训中受益，但很少（13%，168名中的21名）报告接受过先前的培训。
尽管实习生报告经常参与具有临床影响的短缺管理，但实习生与指导医师或患者之间的药品短缺沟通似乎是零星的。药品短缺管理培训并不常见，但被认为是有益的。
