Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA.
Department of Pharmacy, UNC Health, Morrisville, NC, USA.
Am J Health Syst Pharm. 2021 Jul 9;78(14):1309-1316. doi: 10.1093/ajhp/zxab152.
Pharmacy departments across the country are problem-solving the growing issue of drug shortages. We aim to change the drug shortage management strategy from a reactive process to a more proactive approach using predictive data analytics. By doing so, we can drive our decision-making to more efficiently manage drug shortages.
Internal purchasing, formulary, and drug shortage data were reviewed to identify drugs subject to a high shortage risk ("shortage drugs") or not subject to a high shortage risk ("nonshortage drugs"). Potential candidate predictors of drug shortage risk were collected from previous literature. The dataset was trained and tested using 2 methods, including k-fold cross-validation and a 70/30 partition into a training dataset and a testing dataset, respectively.
A total of 1,517 shortage and nonshortage drugs were included. The following candidate predictors were used to build the dataset: dosage form, therapeutic class, controlled substance schedule (Schedule II or Schedules III-V), orphan drug status, generic versus branded status, and number of manufacturers. Predictors that positively predicted shortages included classification of drugs as intravenous-only, both oral and intravenous, antimicrobials, analgesics, electrolytes, anesthetics, and cardiovascular agents. Predictors that negatively predicted a shortage included classification as an oral-only agent, branded-only agent, antipsychotic, Schedule II agent, or orphan drug, as well as the total number of manufacturers. The calculated sensitivity was 0.71; the specificity, 0.93; the accuracy, 0.87; and the C statistic, 0.93.
The study demonstrated the use of predictive analytics to create a drug shortage model using drug characteristics and manufacturing variables.
全国范围内的药房部门正在解决药品短缺这一日益严重的问题。我们旨在将药品短缺管理策略从被动反应转变为更具前瞻性的方法,采用预测数据分析。通过这样做,我们可以推动决策,更有效地管理药品短缺。
审查内部采购、处方和药品短缺数据,以确定易发生短缺风险的药品(“短缺药品”)或不易发生短缺风险的药品(“非短缺药品”)。从先前的文献中收集潜在的短缺风险预测指标候选物。使用两种方法(包括 k 折交叉验证和 70/30 分区到训练数据集和测试数据集)对数据集进行训练和测试。
共纳入 1517 种短缺药品和非短缺药品。用于构建数据集的候选预测因子包括剂型、治疗类别、管制物质表(表 II 或表 III-V)、孤儿药状态、仿制药与品牌药状态以及制造商数量。预测短缺的阳性预测因子包括药物分类为仅静脉内、口服和静脉内、抗生素、镇痛药、电解质、麻醉剂和心血管药物。预测短缺的阴性预测因子包括药物分类为仅口服剂、仅品牌剂、抗精神病药、表 II 药物或孤儿药,以及制造商总数。计算出的敏感性为 0.71;特异性为 0.93;准确性为 0.87;C 统计量为 0.93。
该研究展示了使用预测分析来创建基于药物特性和制造变量的药品短缺模型的方法。