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供应链中断和药品短缺对药物使用的影响:一项范围综述

Impact of Supply Chain Disruptions and Drug Shortages on Drug Utilization: A Scoping Review.

作者信息

Santhireswaran Araniy, Chaudhry Shanzeh, Ho Martin, Fuller Kaitlin, Gaudette Etienne, Burry Lisa, Tadrous Mina

机构信息

Leslie dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.

Angus L. Macdonald Library, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.

出版信息

Pharmacoepidemiol Drug Saf. 2025 Jul;34(7):e70178. doi: 10.1002/pds.70178.

Abstract

PURPOSE

Drug shortages are a growing challenge in health systems across the world. A better understanding of the impacts of shortages on patient drug access and use will guide policies aimed at mitigating shortages. This scoping review aims to summarize observational literature assessing the impact of drug shortages on drug utilization trends.

METHODS

We searched Ovid MEDLINE and Ovid EMBASE for studies published between 1946 and September 17, 2024. An extensive grey literature search was conducted through targeted website searches, grey literature databases, and the Google search engine. Observational studies examining the impacts of drug shortages on drug use were included. Study screening and extraction were conducted by two independent reviewers.

RESULTS

We identified 55 published articles and five gray literature reports. Most studies were conducted in North America (n = 42, 70%). Population-level data were most used (n = 34, 57%), and most studies used drug prescription data to assess changes in use (n = 30, 55%). Most studies reported changes in drug use as a percent change, and the magnitude in decreases ranged from 1% to 99%. Many different data sources, methods, and measures were used to study the impact of drug shortages on drug utilization, and a broad range of decreases in drug utilization following the shortages were reported.

CONCLUSIONS

It is important to synthesize findings across studies to understand how different drugs and settings are affected by shortages. The findings here will inform future studies aimed at filling this knowledge gap, ultimately yielding real-world evidence that can guide policy decisions to address drug supply challenges.

摘要

目的

药品短缺是全球卫生系统中日益严峻的挑战。更好地了解短缺对患者药品可及性和使用的影响,将为旨在缓解短缺的政策提供指导。本综述旨在总结评估药品短缺对药物利用趋势影响的观察性文献。

方法

我们在Ovid MEDLINE和Ovid EMBASE中检索了1946年至2024年9月17日发表的研究。通过有针对性的网站搜索、灰色文献数据库和谷歌搜索引擎进行了广泛的灰色文献搜索。纳入了考察药品短缺对药物使用影响的观察性研究。由两名独立评审员进行研究筛选和提取。

结果

我们确定了55篇已发表文章和5份灰色文献报告。大多数研究在北美进行(n = 42,70%)。最常使用人群水平数据(n = 34,57%),且大多数研究使用药物处方数据评估使用变化(n = 30,55%)。大多数研究将药物使用变化报告为百分比变化,下降幅度从1%到99%不等。许多不同的数据来源、方法和测量指标被用于研究药品短缺对药物利用的影响,且报告了短缺后药物利用的广泛下降情况。

结论

综合各项研究结果对于了解不同药物和环境如何受到短缺影响很重要。此处的研究结果将为未来旨在填补这一知识空白的研究提供信息,最终产生可指导应对药品供应挑战的政策决策的实际证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c1/12215599/7475ebb4378c/PDS-34-e70178-g001.jpg

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