Extemporaneous Compounding Practice by Pharmacists: A Systematic Review

Abstract

Objective: To identify the frequency and scope of extemporaneous compounding practice reported in community and hospital pharmacies.Methods: A systematic literature review was undertaken to identify the prevalence of extemporaneous compounding practice in community and hospital pharmacies, including the reasons of providing compounding services.Results: Nine studies were identified and evaluated in which extemporaneous products prepared by pharmacist could be identified. Most of the studies record that prevalence of extemporaneous compounding practice is very low (less than 5%). Prescribing of compounded medicines occurs more frequently in paediatrics and for special patients' need. The major types of extemporaneous compounding products were dermatological dosage forms and followed by oral solutions and oral suspensions. Reasons for providing compounding practice were to make a customised products that not available commercially and to provide full pharmaceutical care to patients. Issues about the stability of compounded products, accuracy in dose strength and lack of standardised protocol in extemporaneous compounding need to be addressed. Conclusion:Extemporaneous compounding practice are an essential part of pharmacist' competency. These unique skills need to be preserved and regulations that cover rationalised compounding practice is necessary.

Opinion and Expectation of Pharmacists on Providing Extemporaneous Compounding in Jogjakarta and Central Java Provinces, Indonesia

“…Extemporaneous compounding is 'the preparation and supply of a single unit of a product intended for immediate use by a specific consumer' [1][2][3]. The current study shows that in Indonesia, many pharmacies provided extemporaneous compounding.…”

“…Extemporaneous compounding is needed since physicians sometimes change ingredient dose or combine ingredients to create a medication tailored to the needs of an individual patient. On the other hand, extemporaneous compounding medications is individualized and have not been well standardized [1,2], which lead to poor quality products [1][2][3].…”

The Extemporaneous Compounding at Primary Health Care Centers: Characteristic and Personnel

“…Based on previous studies, the prevalence of extemporaneous compounding practices in several countries are quite low with a prevalence below 5% (Kristina, Wiedyaningsih, Widyakusuma, & Aditama, 2017). However, cases of extemporaneous compounding in Indonesia are quite prevalent, especially in Primary Health Care Centers due to unavailability or limited formula for pediatric patients or limited budget in the procurement of medicines in Primary Health Care Center (Widyaswari & Wiedyaningsih, 2012).…”

“…Puyer is the traditional name in Indonesia for pulverizing and or mixing a type of medicine tablet or more, or opening capsule for its contain. Meanwhile in some other countries, most of the compounded medicines are semi-solid preparations for topical application (Kristina et al, 2017). Dermatology preparations in form of topical medicines are generally compounded in some developed countries such as United States of America (the US), Australia, and Netherland.…”

Development and validation of tetracycline hydrochloride assay procedure by spectrophotometry in compounded ointment

“…Drugs prepared in the pharmacy offer a more individual approach to disease treatment, namely they allow to select doses of drug substance depending on the patient condition (1,2). Also compounded preparations provides the opportunity to change the substance composition taking into account patient allergies (3,4).…”