DEPARTMENT OF DRUG DESIGN AND PHARMACOLOGY
FACULTY OF HEALTH AND MEDICAL SCIENCES
UNIVERSITY OF COPENHAGEN
Barriers and facilitators to implement drug changes
caused by drug tenders and shortages
R. Rishoej1, L. L. Christrup1, M. H. Clemmesen2
1Department
2The
of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
Danish Research Unit for Hospital Pharmacy (SAFE), AMGROS I/S, Dampfærgevej 22, 2100 Copenhagen Ø, Denmark.
Background:
Methods:
Drug changes caused by drug tenders and shortages can
Six focus group interviews were conducted at three hospitals in
adversely affect patient safety and the working procedures
different regions of Denmark. At each hospital two focus groups
of healthcare professionals (1, 2).
were conducted, one including physicians and nurses and one
including pharmacists and pharmacy technicians, respectively.
Objectives:
The focus groups consisted of three to four participants. A semi-
Identification of barriers and facilitators for implementing
structured interview guide was applied and the interviews were
drug changes due to drug tenders and shortages in
audio-recorded,
Danish public hospitals.
categorized through content analysis.
verbatim
transcribed
and
thematically
Results:
Identified barriers and facilitators to implement drug changes were divided into the following categories:
Barriers related to drug features
Facilitators related to drug features
- Frequent change of names, packages and labels complicates
correct prescription and identification of drug in medication
room
-
Barriers related to economics and organization
Facilitators related to drug economics and organization
- Drug tender rely on price and does not include other aspects
such product characteristics and patient safety
- Identification of drug substitute in case of drug shortage is
time-consuming
- Inclusion of the hospital pharmacy to a higher degree in the drug
tender process
- Improved national coordination and sharing of information on drug
identification
Barriers related to communication
Facilitators related to communication
- Inadequate and untimed information on drug changes from
pharmacy to ward
- Inadequate drug information provided in cases where a nonlicensed drug has to be used
- Centralized preparation of drug information
- Improved quality and timing of information
Barriers related to technology
Facilitators related to technology
- Lack of quality and quality assurance of electronic systems
- Inadequate education of health care professionals in the use
of electronic systems
- Implementation of clinical decision support in electronic physician order
entry systems
- Implementation of barcode scanning systems
- Education of nurses and physicians in electronic order entry systems
by hospital pharmacists
Introduction of generic prescription
Introduction of barcode scanning of packages
Separation of look-a-like/sound-a-like drugs in medication room
Written alerts in the medication room regarding drug changes
Conclusion:
In the present study barriers and facilitators for implementing drug changes were identified. The barriers and facilitators
included features related to drugs, communication, health care technology as well as to economical and organizational
aspects. Future studies should focus on alleviation of barriers and development and implementation of appropriate
facilitators, which may improve patient safety and the working procedures of healthcare professionals during drug
changes.
References:
1: Hakonsen H. et al. Adv. Ther. 2010; 27: 118-126. 2: Fox ER, Tyler LS, Am. J. Health Syst. Pharm. 2003; 60: 245-253
EAHP 2015 – PS-109