Compounding medications in a rural setting: an interprofessional perspective

Taylor, Selina; Hays, Catherine; Glass, Beverley

doi:10.2147/jmdh.s156161

Cited by 11 publications

(11 citation statements)

References 28 publications

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“…Most community pharmacists (nearly 70%) accepted compounding as a component of pharmaceutical care. In most of the studies, major reasons stated by physicians for prescribing extemporaneous products were that they worked well for certain conditions and that the product was not available commercially [1][2][3][4][5][6][7] .…”

Section: Rationale Of Extemporaneous Compoundingmentioning

confidence: 99%

Extemporaneous Compounding: Cautions, Controversies and Convenience

Mohiuddin

2019

ijmhs

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Pharmacists are only knowledgeable and skilled healthcare professionals dedicated to compounding and preparing medications to meet the unique needs of patients. The safe and effective extemporaneous compounding of prescription products for patients require in special care is fundamental to the pharmacy profession. But there are much to do for secundum artem. It is not at all economical for a pharmaceutical company to marketize a product in 10 different probable doses or in 5 different dosage forms to meet the needs of the entire range of individuals receiving therapy. Although development is a continuous process, companies are customizing features to meet the majority of patient needs, but the very nature of the process cannot meet all patient needs. The risk-benefit ratio of using traditionally compounded medicines is favorable for patients who require specialized medications that are not commercially available, as they would otherwise not have access to suitable treatment. However, if an FDA-approved drug is commercially available, the use of an unapproved compounded drug confers additional risk with no commensurate benefit. Published reports of independent testing by the FDA, state agencies, and others consistently show that compounded drugs fail to meet specifications at a considerably higher rate than FDA-approved drugs. Compounded sterile preparations pose the additional risk of microbial contamination to patients. In the last 11 years, three separate meningitis outbreaks have been traced to purportedly 'sterile' steroid injections contaminated with fungus or bacteria, which were made by compounding pharmacies. The 2012 outbreak has resulted in intense scrutiny of pharmacy compounding practices and increased recognition of the need to ensure that compounding is limited to appropriate circumstances. Purpose of The Study:The article aims to physico-chemical and economic considerations before compounding; factors and quality control issues; compounding support, training, chemical supplies, types of compounding (specially in hospital and ambulatory care compounding). It should aid to practice the extemporaneous preparation of basic and advanced formulations including pharmacopoeial and non-pharmacopoeial formulations encountered in pharmacy practice, together with requisite documentation, labeling, packaging and counseling requirements. Along with this, they have to study the analysis of formulations and their components and relate these to the clinical performance of medicines. This will help them to investigate, evaluate and report the physical characteristics of formulations including release kinetics and relate these to quality control and preformulation requirements; relate the application of quality control, quality assurance and the principles of good manufacturing practice to regulation of medicine production in home and abroad.

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Section: Rationale Of Extemporaneous Compoundingmentioning

confidence: 99%

Extemporaneous Compounding: Cautions, Controversies and Convenience

Mohiuddin

2019

ijmhs

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“…Nevertheless, extemporaneous compounding is still a relevant pharmaceutical service provided by many pharmacies worldwide [3–8]. The continued need for extemporaneous compounding in the age of pharmaceutical manufacturing is driven by the individualized patient care focusing on the therapeutic needs of patients with rare diseases [9], pediatric patients [10–12] and patients with requirements for special dosage forms, individualized dosing or active ingredients combination that are not provided commercially [1, 2, 6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, determinants, and characteristics of extemporaneous compounding in Jordanian pharmacies

AlKhatib

Jalouqa

Maraqa

et al. 2019

BMC Health Serv Res

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BackgroundPharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies.MethodsThis study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and verbally responded to the questions.ResultsResults revealed that 223 (51.7%) of the surveyed pharmacies practiced extemporaneous compounding. The main reason for not providing extemporaneous compounding services was lack of prescription orders for compounded preparations (53.8%). The second reason was lack of the equipment and supplies necessary for compounding (24.4%). Extemporaneous compounding prescriptions were mainly issued by dermatologists (98.2%); dermatological indication was the most common of all extemporaneous compounded prescriptions. The main reason for requesting compounded medications was the lack of a commercially available product (87.9%). The vast majority of the compounded dosage forms were creams (99.6) and ointments (91.5), followed by solutions (23.3%). Only 5 (2.2%) of the studied compounding pharmacies prepared sterile products. The major sources for compounding protocols were the physician order (94.2%), and ‘in-house’ protocols (44.8%). However, the main resource for estimating compounded medications expiration date was information based on pharmacist’s experience (57.8%) and the physician’s order (53.4%).ConclusionsExtemporaneous compounding is a common element of pharmaceutical care. Topical preparations are the most commonly compounded products. Finding from this study suggest that there is a need for standardizing the compounded product formularies, product quality testing, and improving the consistency in estimation of an expiration date of compounded products.

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“…[14,15] In addition, developing collaborative interprofessional pharmaceutical services with other health professional students would be beneficial for improving patient care. [16] Efforts to improve training and education of pharmacy staff, environmental control, quality assurance, and sterilization practices would generate safe compounded medications as recommended by the FDA. [17] Furthermore, adoption of the standardized United States Pharmacopeia guidelines or any other suitable guidelines by regulatory bodies such as the Ministry of Health and IPA had the potential to be a significant step forward in improving compounding pharmacy practices and ensuring the quality and safety of the compounded products.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Kristina¹

2018

AJP

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Introduction: Compounding practice in pharmacy is common, especially in the developing countries. However, the practice of compounding has not been well standardized, as it may lead to cross-contamination or low-quality products. Compounding practice may be influenced by many factors such as patient, health system, and economic issues. The purpose of this study was to determine the extent of compounding practice by pharmacists and to explore factors that influence pharmacists' reasons to provide compounding services. Materials and Methods: The study was a cross-sectional survey using a self-administered questionnaire. Participants were pharmacists in charge in Yogyakarta Province area, working at pharmacies, hospitals, or clinics which provide pharmacy services. An anonymous questionnaire was sent door to door in practice sites. Data were analyzed descriptively. Findings: Among the 425 pharmacists who were contacted, 305 agreed to participate in the survey, giving a response rate of 71%. Overall, 286 (94.08%) pharmacists provided compounding services. Compounded prescriptions accounted for 155 (11.55%) of the 1342 total prescriptions dispensed per month. About 265 (40.4%) pharmacists reported that their aim to provide full pharmaceutical care to patients was one of the most important reasons for providing compounding service. About one-third of compounded prescriptions, 208 (30.1%), were general practitioners, while the remaining were specialized physicians. The three most commonly prescribed dosage forms were powder (32.1%), capsule (25.3%), and syrup (21.9%). The most frequent drug compounded was paracetamol (28.1%), chlorpheniramine maleate (11.4%), and ambroxol (10.6%). Regarding the pharmacists' perception to control the quality of compounded products, most of the pharmacists answered that they feel confident in the quality of compounding because of the guideline provided (80.26%), documenting all procedure in compounding (73%), and the availability of special room for compounding (56.58%). Conclusion: Compounding service remains a core component of pharmacy practice. There is a need to develop evidence-based regulations for compounding practice by pharmacists.

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Compounding medications in a rural setting: an interprofessional perspective

Cited by 11 publications

References 28 publications

Extemporaneous Compounding: Cautions, Controversies and Convenience

Extemporaneous Compounding: Cautions, Controversies and Convenience

Prevalence, determinants, and characteristics of extemporaneous compounding in Jordanian pharmacies

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