Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
Department of Education, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
BMC Health Serv Res. 2021 Aug 17;21(1):827. doi: 10.1186/s12913-021-06812-7.
The shortage of medicines represents a complex global phenomenon that triggers patient care and safety issues. The study was undertaken to explore the impact of medicines shortages on patients in Pakistan. The study also identified barriers which hinder the solutions of medicines shortages issue.
A qualitative study design was adopted and the data was collected in stages between July and September 2019using an in-depth interview approach. The purposive and convenient sampling strategy was used to recruit the study participants. Sample size was limited by using the saturation point criteria. All interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.
A total of 35 stakeholders including 13 physicians, 12 pharmacists and 10 patients participated in the study. The findings of the study were classified into five key themes and seven subthemes. The five themes included, 'impact of medicine shortages on patients', 'patients' practices in response to medicine shortages', 'influence of medicines shortages on medical practice or pharmaceutical business', 'barriers to solutions for medicines shortages', and 'suggestions to assuage the impact of medicine shortages.'This study showed that the medicine shortages had significant clinical and financial impact on patients. Patients' opted for a number of risk-prone practices to avoid treatment disruption during shortages. An array of pharmaceutical market, medicines quality and patient related factors refrain physicians to switch from brand name medicine to generics and lead to ineffective management of medicines shortages. Promotion of generic prescription, implementation of punitive policies and proper patient consultation was advised to assuage the impact of medicine shortages on patients.
The adverse clinical, economic and humanistic impact affirmed in this study demand the introduction of risk-management strategies for medicines shortages in hospital and community settings in accordance with the international standards. Promotion of effective patient counselling by the healthcare professionals to deter risk-prone practices associated with medicines shortages is mandatory.
药品短缺是一个复杂的全球现象，会引发患者护理和安全问题。本研究旨在探讨药品短缺对巴基斯坦患者的影响。研究还确定了阻碍解决药品短缺问题的障碍。
采用定性研究设计，于 2019 年 7 月至 9 月分阶段使用深入访谈方法收集数据。采用目的抽样和便利抽样策略招募研究参与者。根据饱和点标准，将样本量限制在一定范围内。所有访谈均进行录音，逐字转录，并使用主题分析进行分析。
共有 35 名利益相关者参加了研究，包括 13 名医生、12 名药剂师和 10 名患者。研究结果分为五个主要主题和七个子主题。五个主题包括：“药品短缺对患者的影响”、“患者应对药品短缺的做法”、“药品短缺对医疗实践或制药业务的影响”、“解决药品短缺的障碍”和“缓解药品短缺影响的建议”。本研究表明，药品短缺对患者的临床和经济有重大影响。为避免短缺期间治疗中断，患者采取了许多有风险的做法。药品市场、药品质量和患者相关因素的多样性阻止医生从名牌药品转为仿制药，导致药品短缺管理无效。建议推广通用处方、实施惩罚性政策和适当的患者咨询，以减轻药品短缺对患者的影响。
本研究证实了药品短缺对临床、经济和人文造成的不利影响，这就要求按照国际标准在医院和社区环境中引入药品短缺风险管理策略。医疗保健专业人员必须加强对患者的有效咨询，以阻止与药品短缺相关的高风险做法。
