Drug shortages in large hospitals in Riyadh: a cross-sectional study

AlRuthia, Yazed; Alkofide, Hadeel; AlAjmi, Refaa'h; Balkhi, Bander; Alghamdi, Ahmed; Alnasser, Albandari; Alayed, Areej; Alshammari, Maali D.; Alsuhaibani, Danah; Alathbah, Asma

doi:10.5144/0256-4947.2017.375

Cited by 26 publications

(44 citation statements)

References 22 publications

(63 reference statements)

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“…A range of other clinical outcomes were also measured and reported in studies including drug-resistant mutations [49], use of inferior treatments [50, 51], rationing of medications [35, 52], quality of patient care [12, 13, 23], mechanical ventilation [48], and seizure frequency [22]. These can be seen in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Importantly, medication shortages have the potential to impact patient outcomes. The literature has reported that shortages have put economic burdens on the health system, interfered with patient care, and have led to patient dissatisfaction [12, 13]. Medication shortages have also been reported to increase patient out of pocket costs [13, 14] and most alarmingly they have led to adverse patient events including mortality, treatment changes, inferior treatment, and medication errors [13, 15].…”

Section: Introductionmentioning

confidence: 99%

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The impacts of medication shortages on patient outcomes: A scoping review

et al. 2019

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Background In recent years, medication shortages have become a growing worldwide issue. This scoping review aimed to systematically synthesise the literature to report on the economic, clinical, and humanistic impacts of medication shortages on patient outcomes. Methods Medline, Embase, Global Health, PsycINFO and International Pharmaceutical Abstracts were searched using the two key concepts of medicine shortage and patient outcomes. Articles were limited to the English language, human studies and there were no limits to the year of publication. Manuscripts included contained information regarding the shortage of a scheduled medication and had gathered data regarding the economic, clinical, and/or humanistic outcomes of drug shortages on human patients. Findings We found that drug shortages were predominantly reported to have adverse economic, clinical and humanistic outcomes to patients. Patients were more commonly reported to have increased out of pocket costs, rates of drug errors, adverse events, mortality, and complaints during times of shortage. There were also reports of equivalent and improved patient outcomes in some cases. Conclusions The results of this review provide valuable insights into the impact drug shortages have on patient outcomes. The majority of studies reported medication shortages resulted in negative patient clinical, economic and humanistic outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impacts of medication shortages on patient outcomes: A scoping review

et al. 2019

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“…An exploratory qualitative analysis using stakeholder discussion for data generation was conducted. The discussion points were generated after conducting extensive literature review of similar studies (Fox et al, 2014, Reis and Perini, 2008, Gray and Manasse, 2012, Pauwels et al, 2014, Balkhi et al, 2013, Pauwels et al, 2015, Alsheikh et al, 2016, Setayesh and Mackey, 2016, Alshehri and Alshammari, 2016, AlRuthia et al, 2017, Food and Drug Administration Safety and Innovation Act, USC, 2012, Iqbal et al, 2017, Haaijer and Joncheere, 2003, WHO, 1988, MSH, 2009, WHO, 2017, APICS, 2014, Rasooldeen, 2017, Barlas, 2013, Yang et al, 2016). The topics included to guide the discussion were: current situation of drug shortages in Saudi Arabia, major factors contributing to drug shortages, challenges and obstacles to improve drug supply, and stakeholders’ recommendations for managing drug shortages.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have investigated the prevalence and causes of drug shortages in different countries and health care institutions (Pauwels et al, 2014, Balkhi et al, 2013, Pauwels et al, 2015, Alsheikh et al, 2016, Setayesh and Mackey, 2016). Although a few studies have investigated drug shortages in Saudi Arabia, most of these studies were based on questionnaires administered to hospital pharmacists to explore the prevalence of drug shortages and how their institutions are coping with them (Alshehri and Alshammari, 2016, AlRuthia et al, 2017). Nevertheless, the root causes of drug shortages in Saudi Arabia have not been fully investigated before mainly due to the unavailability of published data.…”

Section: Introductionmentioning

confidence: 99%

Drug shortages in Saudi Arabia: Root causes and recommendations

AlRuthia

Alotaibi

Asiri

et al. 2018

Saudi Pharmaceutical Journal

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Drug shortages are a multifaceted problem that has been recurring in Saudi Arabia over the past decade with its significant negative impact on patient care. However, there is a dearth of evidence about possible domestic reasons, if any, behind this recurring problem. Recently, the Pharmacy Education Unit at King Saud University College of Pharmacy has called for a meeting with multiple stakeholders from academia, pharmaceutical care, pharmaceutical industry, purchasing and planning, and regulatory bodies to unveil the root domestic causes of the drug shortages in the Kingdom. Four major topics were used to guide the discussion in this meeting, including: current situation of drug shortages in Saudi Arabia, major factors contributing to drug shortages, challenges and obstacles to improve drug supply, and stakeholders’ recommendations to manage drug shortages. The meeting was audio-recorded and transcribed into verbatim by five authors. The text was then reviewed and analyzed to identify different themes by the first and third authors. Multiple causes were identified and several recommendations were proposed. The main domestic causes of drug shortages that were explored in this study included poor medication supply chain management, lack of government regulation that mandates early notification of drug shortages, a government procurement policy that does not keep pace with the changes in the pharmaceutical market, low profit margins of some essential drugs, weak and ineffective law-violation penalties against pharmaceutical companies and licensed drug importers and distributors, and overdependence on drug imports. The participants have also proposed multiple recommendations to address drug shortages. Policy makers should consider these factors that contribute to drug shortages in Saudi Arabia as well as the recommendations when designing future initiatives and interventions to prevent drug shortages.

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“…In Saudi Arabia, drug shortages have been frequently reported over the past five years due to a multitude of reasons [ 10 , 11 , 12 , 13 ]. However, this pandemic has exacerbated the situation both locally and globally [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on Essential Medicines and Personal Protective Equipment Availability and Prices in Saudi Arabia

et al. 2021

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This was a questionnaire-based cross-sectional study that explored the impact of the COVID-19 pandemic on the availability of essential medicine and personal protective equipment (PPE) in Saudi Arabia. Purposive sampling technique was used to recruit individuals working in the supply chain departments in different healthcare sectors in Saudi Arabia. One hundred and three pharmaceutical and medical supply chain employees participated in the study. Most of the participants (58.3%) were aged ≥35 years, male (65%), and pharmacists (92.2%). The majority of participants had at least two years of experience in supply chain (77.6%), worked in public hospitals (95.15%), and were mostly working at healthcare institutions located in Riyadh province (59.2%). Approximately 51% of the participants reported shortages of 10 or more essential drugs. Tocilizumab, hydroxychloroquine, lopinavir/ritonavir, ribavirin, dexamethasone, enoxaparin, interferon beta-1b, cisatracurium besylate, prednisolone, hydrocortisone, methimazole, and methylprednisolone were reported to be in shortage by at least 8% of the participants. Almost 70% of the participants reported that the pandemic did not significantly impact the prices of prescription drugs in shortage (e.g., ≥25%). Moreover, about 70% of the participants reported direct purchasing or procurement of drugs in shortage. Surgical masks, face shields, medical gowns, and N95 respirators were reported to be in short supply by 33% or more of the participants. Approximately 53% of the participants reported the prices of PPE in shortage had seen an increase by at least 25% during the pandemic. Although the COVID-19 pandemic has caused a significant disruption in the global pharmaceutical supply chain, its impact was largely manageable in Saudi healthcare institutions. This can be attributable to multiple reasons such as the effective exchange programs between hospitals and the drastic increase in public healthcare spending to ameliorate the negative impact of the pandemic on the healthcare sector.

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Drug shortages in large hospitals in Riyadh: a cross-sectional study

Cited by 26 publications

References 22 publications

The impacts of medication shortages on patient outcomes: A scoping review

The impacts of medication shortages on patient outcomes: A scoping review

Drug shortages in Saudi Arabia: Root causes and recommendations

The Impact of COVID-19 on Essential Medicines and Personal Protective Equipment Availability and Prices in Saudi Arabia

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