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Background It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. Methods A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). Results 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p < 0.001) while the fewest patients were in H-SE (1 %, N = 1/100, p = 0.001). In addition, 82.5 %, (N = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. Conclusions Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust.

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Background/Aim: The evidence showed that in the development of diabetes mellitus type 2 (DMT2) and coronary heart disease (CHD) significant role is played by metabolic risk factors: insulin resistance (IR), dyslipidaemia and obesity. Beside metabolic factors, increase in inflammatory markers such as fibrinogen and hs-C reactive protein (hsCRP) plays a role in developing CHD. Metabolic disorders are thought to also be present in patients with impaired glucose tolerance (IGT) and could contribute to development of CHD in these individuals. Aim of this study was to investigate the behaviour of metabolic parameters and chronic inflammation markers in patients with IGT on glucose tolerance test and associated CHD. Methods: The trial included 4 groups of 30 subjects: a) IGT with CHD, b) IGT without CHD, c) CHD without IGT and d) control group without CHD and with normal glucose tolerance (NGT). Within each group glucoregulation parameters were measured (fasting glucose and Hb1Ac). Oral glucose tolerance test (OGTT) with 75 g glucose load was performed and IR parameters calculated (using HOMA-IR, Matsuda index, Quicki index, HOMA1%B), lipid profile was done, waist/hip ratio was measured, as well as fibrinogen and hsCRP. CHD diagnosis was determined by typical signs of previous myocardial infarction on ECG, echocardiogram and/or ergometry (Bruce protocol). Results: Subjects with IGT, but no CHD and those with both IGT and CHD had statistically significantly higher triglyceride and cholesterol levels and manifest IR with decreased insulin sensitivity compared to subjects with CHD, but no IGT and control group. Group with both IGT and CHD was found to have significantly higher fibrinogen and hsCRP concentrations. Conclusion: IR and hyperlipidaemia, together with chronic inflammation mediators, are potential predictors of the development of glucose tolerance disorders; hence interventional treatment during IGT period or during hyperinsulinaemia could give patients better opportunity to prevent or postpone onset or development of diabetes and its complications.

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