Addressing Drug Shortages at Mediclinic Parkview Hospital: A ‎Five-Year Study of ‎Challenges, Impact, and Strategies.

Mohammed Sallam, Albert Oliver, Doaa Allam, Rana Kassem, Mais Damani
Author Information
  1. Mohammed Sallam: Department of Pharmacy, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai, ARE.
  2. Albert Oliver: Department of Management, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai, ARE.
  3. Doaa Allam: Department of Pharmacy, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai, ARE.
  4. Rana Kassem: Department of Pharmacy, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai, ARE.
  5. Mais Damani: Department of Pharmacy, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai, ARE.

Abstract

Background Drug shortages have become a significant challenge globally, affecting healthcare delivery and patient outcomes. This study aimed to assess drug shortages' prevalence, causes, and impact at a tertiary care hospital in Dubai, the United Arab Emirates (UAE), providing actionable insights for future mitigation strategies. Methods A retrospective descriptive study was conducted at Mediclinic Parkview (MPAR) Hospital, part of Mediclinic Middle East (MCME), UAE. Data were collected from January 2019 to December 2023. Reported drug shortages were analyzed to assess their frequency, duration, causes, and management, with a focus on identifying trends and underlying factors. Results Drug shortages peaked at 995 in 2020, particularly during the COVID-19 pandemic. The median time spent managing shortages reached 19.5 days per shortage in Q3 2020. Oral forms accounted for the highest frequency (n = 2231), representing 61% of all shortages, followed by topical forms (n = 414, 11%) and injection forms (n = 386, 10%). Most affected drugs were in the infectious disease (n = 547, 15%), cardiovascular (n = 387, 11%), and respiratory (n = 330, 9%) categories. Drug shortages were driven by regulatory issues and manufacturing delays (39%), unknown reasons (29%), and supply chain disruptions exacerbated by the pandemic (10%). A monopoly environment worsened the situation and limited sourcing flexibility, with 66% of shortages linked to zero supply competitors. Tirzepatide (n = 20) and oseltamivir (n = 18) were the drugs most frequently reported to be unavailable over the 60-month study interval. Regarding management efforts, 80% of the time was spent gathering information and communicating with the different stakeholders. The hospital's response included contacting prescribers for alternatives and increased reliance on internal procurement and inter-pharmacy coordination. These shortages caused significant operational strain, with increased workloads and higher costs. Conclusion The study highlighted the need for adopting proactive measures, improved strategies, enhanced communication, and better preparedness to address future drug shortages. Key actions involved investing in technology, strengthening supplier relationships, and advocating for policy reforms to mitigate risks and ensure continuity of care.

Keywords

References

  1. Narrat Inq Bioeth. 2020;10(1):63-78 [PMID: 33416549]
  2. J Pharm Policy Pract. 2022 Jun 13;15(1):42 [PMID: 35698240]
  3. Can J Anaesth. 2020 Oct;67(10):1405-1416 [PMID: 32458267]
  4. Eur J Hosp Pharm. 2020 Jul;27(4):202-208 [PMID: 32471816]
  5. J Pharm Policy Pract. 2023 Jul 18;16(1):91 [PMID: 37464406]
  6. Am J Health Syst Pharm. 2024 Oct 19;: [PMID: 39425966]
  7. Front Pharmacol. 2019 Jul 19;10:763 [PMID: 31379565]
  8. Healthcare (Basel). 2022 Mar 16;10(3): [PMID: 35327033]
  9. Int J Clin Pharm. 2020 Apr;42(2):309-314 [PMID: 32048122]
  10. Br J Clin Pharmacol. 2023 Oct;89(10):2950-2956 [PMID: 37455356]
  11. Cureus. 2024 May 18;16(5):e60545 [PMID: 38887332]
  12. Int J Clin Pharm. 2016 Oct;38(5):1133-41 [PMID: 27383246]
  13. Br J Clin Pharmacol. 2023 Oct;89(10):2957-2963 [PMID: 37455465]
  14. BMC Health Serv Res. 2020 Mar 19;20(1):234 [PMID: 32192481]
  15. Cureus. 2024 Mar 29;16(3):e57176 [PMID: 38681323]
  16. Pharmacy (Basel). 2024 Nov 07;12(6): [PMID: 39585092]
  17. PLoS One. 2019 May 3;14(5):e0215837 [PMID: 31050671]
  18. J Am Coll Clin Pharm. 2021 Sep;4(9):1134-1143 [PMID: 34230910]
  19. Mayo Clin Proc. 2014 Mar;89(3):361-73 [PMID: 24582195]
  20. Front Pharmacol. 2018 Jan 18;8:942 [PMID: 29403372]
  21. Am J Emerg Med. 2021 Jul;45:557-559 [PMID: 32763102]
  22. Front Pharmacol. 2021 Jul 09;12:693426 [PMID: 34305603]
  23. BMC Health Serv Res. 2023 May 10;23(1):468 [PMID: 37165356]
  24. Open Forum Infect Dis. 2018 Apr 23;5(4):ofy068 [PMID: 29732380]
  25. Res Social Adm Pharm. 2022 Apr;18(4):2615-2624 [PMID: 34020898]
  26. Health Policy. 2018 Dec;122(12):1302-1309 [PMID: 30337159]
  27. Am J Health Syst Pharm. 2020 Oct 30;77(22):1874-1884 [PMID: 32710774]
  28. Public Health Pract (Oxf). 2020 Nov 23;1:100060 [PMID: 36101692]
  29. CMAJ Open. 2020 Aug 31;8(3):E535-E544 [PMID: 32873582]
  30. J Pharm Sci. 2023 Jul;112(7):1763-1771 [PMID: 36965844]
  31. J Pharm Pract Res. 2020 Jun;50(3):185-186 [PMID: 34173431]
  32. Res Social Adm Pharm. 2021 Jan;17(1):1946-1949 [PMID: 32446652]
  33. Ann Saudi Med. 2017 Sep-Oct;37(5):375-385 [PMID: 28988252]
  34. Res Social Adm Pharm. 2021 Jan;17(1):1978-1983 [PMID: 32317153]
  35. J Crit Care. 2021 Jun;63:104-105 [PMID: 33019992]
  36. Front Oncol. 2023 Jan 18;12:1055113 [PMID: 36741703]
  37. Neurocrit Care. 2020 Feb;32(1):226-237 [PMID: 31077080]
  38. J Pharm Policy Pract. 2023 Nov 7;16(1):135 [PMID: 37936250]
  39. Am J Health Syst Pharm. 2018 Nov 1;75(21):1742-1750 [PMID: 30061155]
  40. Iran J Pharm Res. 2012 Spring;11(2):565-72 [PMID: 24250480]
  41. Int J Environ Res Public Health. 2022 Dec 06;19(23): [PMID: 36498446]
  42. Pharmacy (Basel). 2024 Sep 06;12(5): [PMID: 39311127]
  43. Pharmacy (Basel). 2023 Jul 21;11(4): [PMID: 37489351]
  44. Saudi Pharm J. 2018 Nov;26(7):947-951 [PMID: 30416350]
  45. Can Pharm J (Ott). 2020 May 29;153(4):198-203 [PMID: 33193918]
  46. Cureus. 2024 Mar 26;16(3):e56965 [PMID: 38665739]
  47. J Health Econ. 2023 Dec;92:102819 [PMID: 37857116]
  48. Pharmaceutics. 2021 Mar 26;13(4): [PMID: 33810412]
  49. BMC Health Serv Res. 2022 Nov 17;22(1):1366 [PMID: 36397073]
  50. PLoS One. 2021 Apr 23;16(4):e0243870 [PMID: 33891609]
  51. CMAJ Open. 2021 Dec 7;9(4):E1128-E1133 [PMID: 34876414]
  52. Saudi Pharm J. 2023 Jun;31(6):948-954 [PMID: 37234344]
  53. Eur J Hosp Pharm. 2023 Dec 27;31(1):79-81 [PMID: 33789989]
  54. J Pharm Policy Pract. 2021 Jan 22;14(1):17 [PMID: 33482871]
  55. Pharmacy (Basel). 2024 Aug 28;12(5): [PMID: 39311123]
  56. PLoS One. 2023 Apr 14;18(4):e0284528 [PMID: 37058524]
  57. PLoS One. 2017 Mar 28;12(3):e0174556 [PMID: 28350827]
  58. J Oncol Pharm Pract. 2022 Jul 15;:10781552221114278 [PMID: 35837718]
  59. Risk Manag Healthc Policy. 2024 Aug 30;17:2083-2095 [PMID: 39228959]
  60. Healthcare (Basel). 2021 Aug 27;9(9): [PMID: 34574887]
  61. Neonatology. 2019;115(2):108-115 [PMID: 30384374]
  62. Hosp Pharm. 2024 Sep 12;:00185787241278142 [PMID: 39544838]
  63. Am J Health Syst Pharm. 2022 Nov 7;79(22):2012-2017 [PMID: 35913934]
  64. F1000Res. 2024 Oct 14;12:1287 [PMID: 39634344]
  65. Br J Clin Pharmacol. 2023 Mar;89(3):1080-1088 [PMID: 36177609]
  66. JAMA Intern Med. 2019 May 1;179(5):710-711 [PMID: 30907925]
  67. Pediatr Blood Cancer. 2024 Apr;71(4):e30871 [PMID: 38279890]
  68. Int J Clin Pharm. 2024 Dec;46(6):1563-1569 [PMID: 39007990]
  69. J Pharm Policy Pract. 2023 Mar 14;16(1):44 [PMID: 36918981]
  70. Value Health. 2018 Nov;21(11):1286-1290 [PMID: 30442275]
  71. J Pharm Policy Pract. 2024 Jul 12;17(1):2372040 [PMID: 39011356]
  72. Pharmacy (Basel). 2023 Oct 18;11(5): [PMID: 37888510]
  73. BMJ Glob Health. 2021 Nov;6(11): [PMID: 34728479]
  74. BMJ Open. 2020 Mar 4;10(3):e034033 [PMID: 32139487]
  75. Mayo Clin Proc. 2020 Aug;95(8):1807-1808 [PMID: 32753158]
  76. Daru. 2013 Dec 19;21(1):69 [PMID: 24355166]
  77. Clin Pharmacol Ther. 2020 Dec;108(6):1150-1155 [PMID: 32521038]
  78. Hosp Pharm. 2023 Apr;58(2):120-124 [PMID: 36890955]
  79. Hosp Pharm. 2022 Aug;57(4):474-481 [PMID: 35898256]
  80. Front Med (Lausanne). 2020 May 12;7:157 [PMID: 32478082]
  81. Viruses. 2024 Oct 07;16(10): [PMID: 39459910]
  82. J Med Internet Res. 2024 Aug 6;26:e51317 [PMID: 39106483]
  83. Eur J Hosp Pharm. 2023 Sep;30(5):297-301 [PMID: 34758973]
  84. J Pediatr Pharmacol Ther. 2021;26(1):21-25 [PMID: 33424496]
  85. Mayo Clin Proc. 2020 Jun;95(6):1112-1115 [PMID: 32312491]
  86. J Oncol Pharm Pract. 2022 Jun;28(4):822-826 [PMID: 33840285]
  87. Narra J. 2022 Aug;2(2):e82 [PMID: 38449699]
  88. Antibiotics (Basel). 2019 Dec 20;9(1): [PMID: 31861923]
  89. Ann Intern Med. 2019 Jan 1;170(1):74-76 [PMID: 30242373]

Word Cloud

Created with Highcharts 10.0.0shortagesn=DrugstudydrugmanagementstrategiesMediclinicformssupplysignificantassesscausescarehospitalUAEfutureParkviewfrequency2020pandemictimespent11%10%drugschainincreasedoperationalpolicyreformsBackgroundbecomechallengegloballyaffectinghealthcaredeliverypatientoutcomesaimedshortages'prevalenceimpacttertiaryDubaiUnitedArabEmirates providingactionableinsightsmitigationMethodsretrospectivedescriptiveconductedMPARHospitalpartMiddleEastMCMEDatacollectedJanuary2019December2023 ReportedanalyzeddurationfocusidentifyingtrendsunderlyingfactorsResultspeaked995particularlyCOVID-19medianmanagingreached195dayspershortageQ3Oralaccountedhighest2231representing61%followedtopical414injection386affectedinfectiousdisease54715%cardiovascular387respiratory3309%categoriesdrivenregulatoryissuesmanufacturingdelays39%unknownreasons29%disruptionsexacerbatedmonopolyenvironmentworsenedsituationlimitedsourcingflexibility66%linkedzerocompetitorsTirzepatide20oseltamivir18frequentlyreportedunavailable60-monthintervalRegardingefforts80%gatheringinformationcommunicatingdifferentstakeholdershospital'sresponseincludedcontactingprescribersalternativesrelianceinternalprocurementinter-pharmacycoordinationcausedstrainworkloadshighercostsConclusionhighlightedneedadoptingproactivemeasuresimprovedenhancedcommunicationbetterpreparednessaddressKeyactionsinvolvedinvestingtechnologystrengtheningsupplierrelationshipsadvocatingmitigaterisksensurecontinuityAddressingShortagesHospital:‎Five-YearStudy‎ChallengesImpactStrategiespharmacymedicationmediclinicmiddleeastefficiencypharmaceuticalrisk

Similar Articles

Cited By