Table 4.
Strategies used to minimize the impact of drug shortages on patient safety and care by hospital sector.
| Strategy | Hospital Sector | Total (n=120) | |||
|---|---|---|---|---|---|
| MOH hospitals (n=29) | MOH-affiliated medical cities (n=38) | Non-MOH hospitals (n=53) | P value | ||
|
| |||||
| Substitute (without consultation with the prescriber/the patient) | 6 (20.69) | 8 (21.05) | 8 (15.09) | .716 | 22 (18.33) |
| Inform prescriber and recommend an alternative drug | 17 (58.62) | 28 (73.68) | 42 (79.25) | .132 | 87 (72.50) |
| Inform the prescriber of the drug shortage | 7 (24.14) | 15 (39.47) | 28 (52.83) | .039 | 50 (41.67) |
| Investigate when supply will be restored and plan stock accordingly | 6 (20.69) | 11 (28.95) | 28 (52.83) | .006 | 45 (37.50) |
| Attempt to source the medicine from an alternative supplier (including another hospital) | 5 (17.24) | 11 (28.95) | 21 (39.62) | .105 | 37 (30.83) |
| Change the formulary based on the information provided | 4 (13.79) | 0 (0.00) | 3 (5.66) | .036 | 7 (5.83) |
| Reassign staff work profiles and job descriptions (e.g., devote staff resources more specifically to dealing | |||||
| with shortages) | 12 (41.38) | 15 (39.47) | 21 (39.62) | .984 | 48 (40.00) |
| Create new communication systems and tools to alert prescribers and other hospital staff about the presence of shortages and the need to substitute replacement therapies | 21 (72.41) | 29 (76.32) | 41 (77.36) | .879 | 91 (75.83) |
| Readjust budget plans due to additional expenditure caused by shortages (e.g., needing to use more expensive replacement therapies) | 14 (48.28) | 13 (34.21) | 22 (41.51) | .505 | 49 (40.83) |
| Cancel practice improvement and development initiatives due to resources having to be reassigned to dealing with the shortages problem | 7 (24.14) | 4 (10.53) | 10 (18.87) | .3273 | 21 (17.50) |
| No changes required | 2 (6.90) | 3 (7.89) | 2 (3.77) | .690 | 7 (5.83) |