Specialised Compounding—Practices and Opinions of Australian Community Pharmacists

Abstract

Background: Anecdotal reports of the increase in dispensing of compounded products have resulted in a review of pharmacy compounding by regulatory authorities. However, little is known about the compounding practices of community pharmacists. Aim: To investigate the extent and nature of compounding in community pharmacies, to assess the differences between specialised and non-specialised compounding practices and to evaluate pharmacists' attitudes to compounding as a specialty. Method: A 42-item self-completion questionnaire was sent to 500 randomly selected Australian community pharmacies. This was followed by 3 additional mailings to non-responders. A final non-respondent telephone survey was also conducted. Results: Inclusion criteria were met by 465 pharmacies. Surveys were completed by 271 pharmacists (58% response rate). Although the extent of compounding is unchanged (less than 1% of prescriptions) some pharmacists have adopted compounding as a specialty practice. Specialised compounding was provided by 9.6% of pharmacies dispensing an average of 25 compounded products weekly compared to 3 products by non-specialised pharmacies. Specialised pharmacies have different equipment and training, and dispensed a variety of dosage forms for a wide range of therapeutic areas. Conclusion: Specialised compounding service is being increasingly offered by community pharmacies. Pharmacists felt strongly that compounding should be provided by all pharmacies but accepted that there should be accreditation of specialised practices. More research is needed to enable the development of appropriate standards and guidelines. J Pharm Pract Res 2007; 37: 260-4.

Community pharmacy compounding–impact on professional status

“…By this we mean extemporaneous preparation of medicines over and above routine practice. Australian researchers found that between 6 and 10% of Australian pharmacies offer compounding as a specialised or enhanced service [62][63][64]. Although research on the characteristics of specialised compounding pharmacies is sparse, a study conducted by the authors uncovered differences in organisational aspects of ''general'' (non-specialist) pharmacies and specialised compounding pharmacies.…”

“…There is evidence that compounding is increasingly being offered in the US and Australia as a specialised or enhanced community pharmacy service [60][61][62][63]. By this we mean extemporaneous preparation of medicines over and above routine practice.…”

A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance

“…Previous mailing surveys conducted among the Australian pharmacies or pharmacists found that the response rates were around 40-60% [36][37][38][39]. Interestingly, all the studies involved self-administered questionnaires which can be completed in a short space of time [36][37][38][39].…”

What is quality of medicines?

“…In Australia, pharmacists not specialising in compounding services still compound on average three products per week and the 10% of pharmacists specialising in compounding average 25 products per week, just under 1% of all prescriptions. 4 In Australia, prescription medicines are registered in the Australian Register of Therapeutic Goods under the Therapeutic Goods Act 1989 ('the Act'). Regulations under the Act (Therapeutic Goods (Manufacturing Principles) Determination no.…”

“…In Australia, both complexity and scale of compounding are increasing. 4 A physician usually focuses on prescription medicines, but there are other products relevant to our patients. Complementary and alternative medicines are products used with therapeutic intent and are a multimillion dollar industry in Australasia.…”