Chapuis Claire, Collomp Rémy, Albaladejo Laura, Terrisse Hugo, Honoré Stéphane, Bosson Jean-Luc, Bedouch Pierrick, Albaladejo Pierre
Pôle Pharmacie, Pôle Anesthésie-Réanimation, CHU Grenoble Alpes, CS10217, 380143, Grenoble cedex 9, France.
Pôle Pharmacie Stérilisation, CHU De Nice, Société Française de Pharmacie Clinique (SFPC), Nice, France.
J Pharm Policy Pract. 2022 Apr 1;15(1):28. doi: 10.1186/s40545-022-00425-z.
Tension in the supply of highly consumed drugs for patients with COVID-19 (propofol, midazolam, curares) led the French government to set up a centralized supply of hospitals with distribution based on the number of resuscitation beds in March 2020. The French Societies of Clinical Pharmacy and of Anesthesia and Critical Care aimed to evaluate the changes in total needs and the distribution between anesthesia and critical care activities (CCU), to prepare resumed surgical activity.
National declarative survey among pharmacists, via an online form (SurveyMonkey®), was conducted in April and May 2020. The analysis focused on quantities dispensed during the whole year 2019, and March and April of year 2019 and 2020 for the drugs subject to quota, and on their distribution in CCU and operating theaters.
For the 358 establishments (47% public, 53% private), dispensations in CCU in March 2020 compared to March 2019 increased, respectively: propofol (+81%), midazolam (+125%), cisatracurium (+311%), atracurium (+138%), rocuronium (+119%); and decreased for anaesthesia: propofol (-27%), midazolam (-10%), cisatracurium (-19%), atracurium (-27%), rocuronium (+16%).
Variation of dispensations between CCU and others was directly related to the increase of COVID patients in CCU and the decrease in surgical activity. Each establishment could receive up to five or six different presentations and concentrations, leading to a major risk of medication error. This collaborative national survey provided accurate data on the drugs' usual consumption. This work emphasized the need for a strong collaboration between pharmacists and anesthesiologists and intensive care physicians. It was further used by the Health Ministry to adjust the drug distribution.
2019冠状病毒病患者常用药物（丙泊酚、咪达唑仑、肌松药）供应紧张，促使法国政府于2020年3月建立了基于重症监护床位数量的医院集中供应及配送机制。法国临床药学协会以及麻醉与重症监护协会旨在评估总需求量的变化以及麻醉与重症监护活动（重症监护病房）之间的分配情况，为恢复外科手术活动做准备。
2020年4月和5月，通过在线表格（SurveyMonkey®）对药剂师进行了全国性的申报调查。分析重点为2019年全年以及2019年和2020年3月及4月配额药物的配发量，以及这些药物在重症监护病房和手术室的分配情况。
对于358家机构（47%为公立，53%为私立），与2019年3月相比，2020年3月重症监护病房的药物配发量分别增加：丙泊酚（+81%）、咪达唑仑（+125%）、顺式阿曲库铵（+311%）、阿曲库铵（+138%）、罗库溴铵（+119%）；而麻醉方面的配发量减少：丙泊酚（-27%）、咪达唑仑（-10%）、顺式阿曲库铵（-19%）、阿曲库铵（-27%）、罗库溴铵（+16%）。
重症监护病房与其他科室之间的配发量变化与重症监护病房新冠患者数量增加及外科手术活动减少直接相关。每家机构可能收到多达五六种不同剂型和浓度的药物，这导致用药错误的重大风险。这项全国性合作调查提供了有关药物常规消耗量的准确数据。这项工作强调了药剂师与麻醉师以及重症监护医生之间加强合作的必要性。卫生部进一步利用这些数据来调整药物配送。
