Patients perspectives on drug shortages in six European hospital settings – a cross sectional study

Darija Kuruc Poje, Domagoj Kifer, Isabelle Huys, Joao Miranda, Helena Jenzer, Nenad Miljković, Torsten Hoppe-Tichy, Marcin Bochniarz, Roberto Frontini, David G. Schwartz, Vesna Vujić-Aleksić, Lana Nežić, Eleni Rinaki, Leonidas Tzimis, Kim Green, Jelena Jovanić, Bojana Carić, Danijela Mandić, Katarina Vilić, Tomasz BochenekVesna Bačić Vrca, Srećko Marušić

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. Methods: A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). Results: 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p < 0.001) while the fewest patients were in H-SE (1 %, N = 1/100, p = 0.001). In addition, 82.5 %, (N = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. Conclusions: Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust.

Original languageEnglish
Article number689
JournalBMC Health Services Research
Volume21
Issue number1
DOIs
StatePublished - 12 Jul 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Funding

Authors would like to acknowledge COST Action CA15105 - European Medicines Shortages Research Network - addressing supply problems to patients (Medicines Shortages) and EAHP (European Association of Hospital Pharmacists) that aided our efforts. Additionally, we would like to share our gratitude to all hospital teams and all the patients that actively participated and therefore significantly contributed to the study.

FundersFunder number
European Association of Hospital Pharmacists
European Cooperation in Science and TechnologyCA15105

    Keywords

    • Drug shortages
    • Europe
    • Hospital setting
    • Patient safety
    • Patients’ perspectives

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