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国家肿瘤药物短缺对临床实践影响的调查:一项血液病肿瘤药学协会调查。

National Survey on the Effect of Oncology Drug Shortages in Clinical Practice: A Hematology Oncology Pharmacy Association Survey.

机构信息

University of Arizona Cancer Center, Tucson, AZ.

Bristol Myers Squibb, WW Health Economics Outcomes Research Markets, Lawrence Township, NJ.

出版信息

JCO Oncol Pract. 2022 Aug;18(8):e1289-e1296. doi: 10.1200/OP.21.00883. Epub 2022 May 11.

Abstract

PURPOSE

Drug shortages are a clear and growing challenge. Prominent shortages included oncology medications and supportive care products essential for the care of patients with cancer. Oncology drug shortages often result in disruptions in the timing of chemotherapy treatments, alterations in the dose or regimen administered, or even missed doses when alternative agents are unavailable. The purpose of this survey was to characterize the impact of oncology drug shortages across the United States, including the experiences of health care organizations, resource implications, and the impact on patient safety, patient care, and clinical trials.

METHODS

A 36-item online survey was distributed to membership of the Hematology/Oncology Pharmacy Association to gather information on shortages of oncology drugs (ie, all drugs essential in the care of patients with cancer, including supportive care agents).

RESULTS

Sixty-eight US organizations participated in the survey between December 2019 and July 2020. Sixty-three percent of institutions reported one or more drug shortages per month, with a 34% increase in 2019 from 2018. Treatment delays, reduced doses, or alternative regimens were reported by 75% of respondents. The most difficult agents to obtain were vincristine, vinblastine, intravenous immunoglobulin, leucovorin, and Bacillus Calmette-Guerin.

CONCLUSION

A survey of US oncology pharmacists indicated that oncology drug shortages occurred frequently in 2020. Shortages led to delays in chemotherapy and changes in treatment or omission, complicated clinical research, and increased risk of medication errors and adverse outcomes.

摘要

目的

药品短缺是一个明显且日益严重的挑战。突出的短缺包括肿瘤学药物和支持性护理产品,这些产品是癌症患者护理的必需品。肿瘤学药物短缺通常导致化疗治疗时间的中断、给予的剂量或方案的改变,甚至在没有替代药物时错过剂量。这项调查的目的是描述美国各地肿瘤学药物短缺的情况,包括卫生保健组织的经验、资源影响以及对患者安全、患者护理和临床试验的影响。

方法

向血液学/肿瘤学药房协会的成员分发了一份 36 项的在线调查,以收集有关肿瘤学药物短缺的信息(即,所有对癌症患者护理至关重要的药物,包括支持性护理药物)。

结果

68 家美国机构在 2019 年 12 月至 2020 年 7 月期间参与了这项调查。63%的机构报告称每月有一个或多个药物短缺,2019 年比 2018 年增加了 34%。75%的受访者报告说有治疗延迟、减少剂量或替代方案。最难获得的药物是长春新碱、长春碱、静脉注射免疫球蛋白、甲酰四氢叶酸和卡介苗。

结论

对美国肿瘤学药剂师的调查表明,2020 年肿瘤学药物短缺经常发生。短缺导致化疗延迟和治疗改变或遗漏,使临床研究复杂化,并增加药物错误和不良后果的风险。

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