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Journal articles on the topic 'Shortages'

Author: Grafiati

Published: 4 June 2021

Last updated: 21 February 2023

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1

Mangan, Michelle N., and Mary F. Powers. "Drug Shortages and the Role of the Pharmacy Technician: A Review." Journal of Pharmacy Technology 27, no. 6 (November 2011): 247–50. http://dx.doi.org/10.1177/875512251102700602.

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Objective: To increase pharmacy technicians' awareness of national drug shortages, enabling them to understand why drug shortages occur and how they can help ameliorate the effects that a drug shortage may have in their workplace. Data Sources: Articles were identified through searches of MEDLINE and PubMed (1950 through July, 2011) using the following search terms: drug shortages, drug shortages and legislation, drug shortages and law, and drug shortages and safety. Additionally, resources on drug shortages from the American Society of Health-System Pharmacists, the FDA, and the Institute for Safe Medication Practices were used. Study Selection and Data Extraction: Articles describing drug shortages, drug shortages and legislation, and managing drug shortages in the health care setting were included. Data Synthesis: The effects of drug shortages on pharmacy departments and the health care system as a whole can place significant strain on pharmacists. Pharmacy technicians can play a key role in the initial management of a drug shortage by being responsible for such tasks as validating shortage details and duration with manufacturers, determining the institution's current stock and history of use of a medication, and remaining up-to-date on current drug shortages to help keep patients and other health care professionals informed. Conclusions: Pharmacy technicians are a valuable resource for pharmacists in the management of drug shortages and can work with pharmacists to perform operational and assessment tasks after a drug shortage has been identified.

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Chen, Emily, Susan Goold, Sam Harrison, Iman Ali, Ibtihal Makki, Stanley S. Kent, and Andrew G. Shuman. "Drug shortage management: A qualitative assessment of a collaborative approach." PLOS ONE 16, no. 4 (April 23, 2021): e0243870. http://dx.doi.org/10.1371/journal.pone.0243870.

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Drug shortages frequently and persistently affect healthcare institutions, posing formidable financial, logistical, and ethical challenges. Despite plentiful evidence characterizing the impact of drug shortages, there is a remarkable dearth of data describing current shortage management practices. Hospitals within the same state or region may not only take different approaches to shortages but may be unaware of shortages proximate facilities are facing. Our goal is to explore how hospitals in Michigan handle drug shortages to assess potential need for comprehensive drug shortage management resources. We conducted semi-structured interviews with diverse stakeholders throughout the state to describe experiences managing drug shortages, approaches to recent shortages, openness to inter-institutional engagement, ideas for a shared resource, and potential obstacles to implementation. To solicit additional feedback on ideas for a shared resource gathered from the interviews, we held focus groups with pharmacists, physicians, ethicists, and community representatives. Among participants representing a heterogeneous sample of institutions, three themes were consistent: (1) numerous drug shortage strategies occurring simultaneously; (2) inadequate resources and lead time to proactively manage shortages; and (3) interest in, but varied attitudes toward, a collaborative approach. These data provide insight to help develop and test a shared drug shortage management resource for enhancing fair allocation of scarce drugs. A shared resource may help institutions adopt accepted best practices and more efficiently access or share finite resources in times of shortage.

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Turbucz, Bela, Martin Major, Romana Zelko, and Balazs Hanko. "Proposal for Handling of Medicine Shortages Based on a Comparison of Retrospective Risk Analysis." International Journal of Environmental Research and Public Health 19, no. 7 (March 30, 2022): 4102. http://dx.doi.org/10.3390/ijerph19074102.

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Introduction: We reviewed and compared current drug shortages and shortage management practices in six selected countries (Hungary, Belgium, Spain, Switzerland, Australia, United States) based on the most comprehensive national shortage databases for each country, for four Anatomical Therapeutic Chemical (ATC) groups, to analyze the criticality of drug shortages across countries and identify best practices in shortage management strategies. Materials and Methods: Countries were selected to cover a wide geographical range of high-income nations where a lack of economic power as a potential source of drug shortages is not observable. ATC groups were selected based on a pre-examination of the databases to analyze groups most often in shortage, and groups where the absence of which could have a severe negative impact on treatment outcomes. The bias originating from the different reporting systems had to be reduced to gain comprehensive and comparable information. The first bias-reducing mechanism was transforming the raw number of shortages into proportion per million people. Secondly, critical cases were classified, and thirdly, critical cases were compared with the Word Health Organization (WHO) Essential Medicine Lists. Results: The results indicate that every European country studied reports significantly higher total and critical shortages per population compared to the US and Australia. Within Europe, Hungary reports the highest number of cases both for total and critical shortages, while Spain has the lowest results in both aspects. While in the US and Australia critical shortages were observable in similar proportions across all ATC groups, in European countries ATC groups of anti-infectives for systemic use (J) and the nervous system (N) were found to account for a notably higher proportion of critical shortages. Current shortage management practices were examined in each country and classified into five groups to identify common best practices. Conclusions: Due to the different characterization of reporting systems, several bias-reducing mechanisms should be applied to compare and evaluate shortages. In addition, European harmonization should be initiated to create mutually acknowledged definitions and reporting systems, which could be the basis of good drug shortage handling practices in Europe.

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Leady, Michelle A., Ann L. Adams, Janice L. Stumpf, and Burgunda V. Sweet. "Drug Shortages: An Approach to Managing the Latest Crisis." Hospital Pharmacy 38, no. 8 (August 2003): 748–52. http://dx.doi.org/10.1177/001857870303800812.

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In recent years, many drug shortages have compromised patient care. Drug shortages can lead to altered therapeutic outcomes, increased risk of medication errors, and increased medical costs. This article presents one hospital's successful algorithm for managing medication shortages. Methods included drafting a shortage policy and procedure; identifying a primary contact person to assess the impact of the shortage; identifying appropriate clinicians to perform research; establishing references for identification of alternative agents; and promptly communicating with and disseminating shortage information to appropriate individuals.

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Omorodion, Jacklyn O., Rami M. Algahtani, Mark S. Zocchi, Erin R. Fox, Jesse M. Pines, and Henry J. Kaminski. "Shortage of generic neurologic therapeutics." Neurology 89, no. 24 (November 15, 2017): 2431–37. http://dx.doi.org/10.1212/wnl.0000000000004737.

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Objective:To assess longitudinal trends in shortages of generic drugs used for neurologic conditions over a 15-year period in the United States.Methods:Drug shortage data from the University of Utah Drug Information Service (UUDIS) from 2001 to 2015 were analyzed. Medications were included that were likely to be prescribed by a neurologist to treat a primary neurologic condition or critical for care of a patient with a neurologic condition. Trends in shortage length were assessed using standard descriptive statistics.Results:A total of 2,081 shortages were reported by UUDIS and 311 (15%) involved medications for neurologic conditions. After excluding discontinued products, 291 shortages were analyzed. The median number of neurologic drugs in shortage was 21 per month with a median duration of 7.4 months. During the three 5-year periods of 2001–2005, 2006–2010, and 2011–2015, a median of 12.5, 14, and 45 drugs were in shortage, respectively. A maximum of 50 drugs in shortage was reached in December 2012 and December 2014. By the end of the study period, 30 neurologic drugs remained in shortage. In over half of the shortages, manufacturers did not provide a reason for the shortage. When reported, manufacturing delays, followed by supply/demand issues, raw material shortages, regulatory issues, and business decisions were cited.Conclusions:Continued drug shortages may compromise the care of patients with neurologic conditions. Manufacturers, together with professional organizations, patient advocacy groups, and the government, need to continue to address this issue, which may escalate with a growing burden of neurologic disease.

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Dowden, Angela. "Will Serious Shortage Protocols help ease drug shortages?" Prescriber 31, no. 5 (May 2020): 29–31. http://dx.doi.org/10.1002/psb.1844.

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Rodriguez-Monguio, Rosa, Mahim Naveed, and Enrique Seoane-Vazquez. "Predictors of shortages of opioid analgesics in the US: Are the characteristics of the drug company the missing puzzle piece?" PLOS ONE 16, no. 3 (March 31, 2021): e0249274. http://dx.doi.org/10.1371/journal.pone.0249274.

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Background Shortages of opioid analgesics are increasingly common, interfere with patient care and increase healthcare cost. This study characterized the incidence of shortages of opioid analgesics in the period 2015–2019 and evaluated potential predictors to forecast the risk of shortages. Methods This was an observational retrospective study using the US Food and Drug Administration (FDA) drug shortages data. All FDA approved opioids were included in the study. Opioid analgesics were identified using the FDA National Drug Codes (NDC) and classified according to the Drug Enforcement Administration (DEA) schedule. We conducted Least Absolute Shrinkage and Selection Operator logistic regression analysis to assess direction of the association between risk of shortage and potential predictors. We used multivariable penalized logistic regression analysis to model predictors of shortages. We split the dataset into training and validation sets to evaluate the performance of the model. Findings The FDA approved 8,207 unique NDCs for opioid analgesics; 3,017 (36.8%) were in the market as of April 30, 2019 and 91(3.0%) of them were listed as in shortage by the FDA. All NDCs in shortage were schedule II opioids; 86 (94.5%) were injectable and 84 (92.3%) generics. There were 418 companies with at least one opioid NDC listed by the FDA. Three companies accounted for more than 4 in 5 of the schedule II active injectable opioids. For each unit increase in the number of prior instances of shortages of a company, the likelihood of an NDC shortage for that company increased by 3.4%. For each unit increase in number of NDCs marketed by a company, the odds of an NDC shortage for that company decreased by 1%. Conclusions In the period 2015–2019, shortages of opioid analgesics disproportionally impacted schedule II and injectable opioids. The risk of shortage of opioid analgesics significantly increased with the incidence of previous instances of shortages of a manufacturing company and decreased with the number of NDCs marketed by a company. The characteristics of the manufacturing company, rather than the number of companies, might be the missing piece to the complex puzzle of drug shortages in the US.

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Patel, Jigar M., Erin R. Fox, Mark Zocchi, Zone-En Lee, and Maryann Mazer-Amirshahi. "Trends in United States Drug Shortages for Medications Used in Gastroenterology." Medicine Access @ Point of Care 1 (January 2017): maapoc.0000012. http://dx.doi.org/10.5301/maapoc.0000012.

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Introduction Drug shortages have become more severe in recent years; however, data describing how such shortages impact gastroenterology (GI) drugs are limited. We characterize longitudinal trends of drug shortages in the USA within the scope of GI practice. Methods Drug shortage data from the University of Utah Drug Information Service were analyzed from January 2001 to December 2014. A board certified gastroenterologist, an internal medicine physician, and a clinical pharmacist identified drug shortages within the scope of GI practice, whether they are used for high-acuity conditions, availability, formulation, or therapeutic category. Trends in the length of shortages for GI drugs were described using standard descriptive statistics and regression analysis. Results A total of 1,774 drug shortages were reported over the 14-year period. Of those, 253 shortages (14.3%) were classified within the scope of GI practice. The number of newly-reported GI drug shortages increased from 15 in 2001 to 44 in 2014. The majority of GI drugs (55.7%) were parenteral and 102 shortages (40.3%) were single source drugs. By the end of the study period, 44 (17.4%) GI drugs remained on active shortage with a median duration of 24.3 months (interquartile range [IQR] 6.9–32.1). The median duration for resolved shortages of GI drugs was 7.7 months (IQR 2.9–17.6). Conclusions There was a significant increase in shortages of drugs used in GI practice from 2001 to 2014. Many of these drugs were used for high-acuity conditions and alternative agents were also impacted. Gastroenterologists must be cognizant of current shortages in order to mitigate impact on patient care.

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Paul, Suchandra. "An Analysis of the Skill Shortage Problems in Indian IT Companies." Social Sciences 7, no. 9 (September 14, 2018): 159. http://dx.doi.org/10.3390/socsci7090159.

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Skill shortage is a crucial social issue which needs to be analyzed thoroughly in any organization. In this paper, the problems related to the skill shortage are analyzed and possible solutions are provided to deal with the problem of skill shortages effectively. This paper will facilitate in helping the organization to find the right talent for the organization thus removing or decreasing the problem of skill shortages. The paper begins with the importance of skills shortage from a theoretical point of view. The problems associated are highlighted and analyzed. The factors which are an integral part of skill shortages are elaborated. Also, an in-depth analysis is carried out by considering the organizations, Tata Consultancy Services and Infosys as a case study. In the final section, various solutions and approaches are laid down to tackle the problems incorporated with skill shortages.

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Omer, Sumaira, Salamat Ali, Sundus Shukar, Ali Hassan Gillani, Yu Fang, and Caijun Yang. "A Qualitative Study Exploring the Management of Medicine Shortages in the Community Pharmacy of Pakistan." International Journal of Environmental Research and Public Health 18, no. 20 (October 12, 2021): 10665. http://dx.doi.org/10.3390/ijerph182010665.

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Managing medicine shortages consumes ample time of pharmacists worldwide. This study aimed to explore the strategies and resources being utilized by community pharmacists to tackle a typical shortage problem. Qualitative face-to-face interviews were conducted. A total of 31 community pharmacists from three cities (Lahore, Multan, and Dera Ghazi Khan) in Pakistan were sampled, using a purposive approach. All interviews were audio taped, transcribed verbatim, and subjected to thematic analysis. The analysis yielded five broad themes and eighteen subthemes. The themes highlighted (1) the current scenarios of medicine shortages in a community setting, (2) barriers encountered during the shortage management, (3) impacts, (4) corrective actions performed for handling shortages and (4) future interventions. Participants reported that medicine shortages were frequent. Unethical activities such as black marketing, stockpiling, bias distribution and bulk purchasing were the main barriers. With respect to managing shortages, maintaining inventories was the most common proactive approach, while the recommendation of alternative drugs to patients was the most common counteractive approach. Based on the findings, management strategies for current shortages in community pharmacies are insufficient. Shortages would continue unless potential barriers are addressed through proper monitoring of the sale and consumption of drugs, fair distribution, early communication, and collaboration.

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Hantel, Andrew, Ashley M. Egan, Trinh T. Nguyen, Erin S. DeMartino, Fay Hlubocky, Samantha Bastow, Mark Siegler, and Christopher K. Daugherty. "A Cross-Sectional Survey of Medical Trainee Experiences During Medication Shortages." Journal of Graduate Medical Education 12, no. 1 (February 1, 2020): 38–43. http://dx.doi.org/10.4300/jgme-d-19-00385.1.

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ABSTRACT Background Medication shortages prevent patients from receiving optimal care. Despite the frequency with which medical trainees care for inpatients, no assessment of their experiences in medication shortage management has been performed. Objective We evaluated trainees' experiences managing medication shortages. Methods We performed a cross-sectional survey of trainees postgraduate year 2 (PGY-2) and above in medicine, anesthesiology, and emergency medicine departments at 2 academic centers in 2018–2019. Categorical and ordinal assessments evaluated shortage awareness, substitution availability, pharmacy and therapeutics committee-based restrictions, communication, and education. Regressions were performed to determine effect of PGY, department, and institution on responses. Results A total of 168 of 273 subjects completed the survey (62% response rate). Most (95%, 159 of 168) reported managing medication shortages during training; 51% (86 of 168) described managing clinically relevant shortages daily or weekly. Seventy-seven percent (129 of 168) noted equivalent alternatives were unavailable at least one-quarter of the time, and 43% (72 of 168) reported clinically necessary medications were restricted at least weekly. Fifty-four percent (89 of 168) and 64% (106 of 167) of respondents discussed clinically relevant shortages with supervising physicians or patients “some of the time” or less, respectively. Most respondents (90%, 151 of 168) reported they would benefit from shortage management training, but few (13%, 21 of 168) reported prior training. Conclusions Although trainees reported frequent involvement in clinically impactful shortage management, medication shortage communication between trainees and supervising physicians or patients appears sporadic. Medication shortage management training is uncommon but perceived as beneficial.

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Grollman, Christopher, Marina A. S. Daniele, Lia Brigante, Gwenan M. Knight, Laura Latina, Andrei S. Morgan, and Soo Downe. "Maternity service reconfigurations for intrapartum and postnatal midwifery staffing shortages: modelling of low-risk births in England." BMJ Open 12, no. 9 (September 2022): e051747. http://dx.doi.org/10.1136/bmjopen-2021-051747.

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IntroductionChoice of birth setting is important and it is valuable to know how reconfiguring available settings may affect midwifery staffing needs. COVID-19-related health system pressures have meant restriction of community births. We aimed to model the potential of service reconfigurations to offset midwifery staffing shortages.MethodsWe adapted the Birthrate Plus method to develop a tool that models the effects on intrapartum and postnatal midwifery staffing requirements of changing service configurations for low-risk births. We tested our tool on two hypothetical model trusts with different baseline configurations of hospital and community low-risk birth services, representing those most common in England, and applied it to scenarios with midwifery staffing shortages of 15%, 25% and 35%. In scenarios with midwifery staffing shortages above 15%, we modelled restricting community births in line with professional guidance on COVID-19 service reconfiguration. For shortages of 15%, we modelled expanding community births per the target of the Maternity Transformation programme.ResultsExpanding community births with 15% shortages required 0.0 and 0.1 whole-time equivalent more midwives in our respective trusts compared with baseline, representing 0% and 0.1% of overall staffing requirements net of shortages. Restricting home births with 25% shortages reduced midwifery staffing need by 0.1 midwives (–0.1% of staffing) and 0.3 midwives (–0.3%). Suspending community births with 35% shortages meant changes of –0.3 midwives (–0.3%) and –0.5 midwives (–0.5%) in the two trusts. Sensitivity analysis showed that our results were robust even under extreme assumptions.ConclusionOur model found that reconfiguring maternity services in response to shortages has a negligible effect on intrapartum and postnatal midwifery staffing needs. Given this, with lower degrees of shortage, managers can consider increasing community birth options where there is demand. In situations of severe shortage, reconfiguration cannot recoup the shortage and managers must decide how to modify service arrangements.

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Buchan, James. "Evidence of nursing shortages or a shortage of evidence?" Journal of Advanced Nursing 56, no. 5 (December 2006): 457–58. http://dx.doi.org/10.1111/j.1365-2648.2006.04072_2.x.

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Woodend, A. Kirsten, Jeff Poston, and Karen Weir. "Drug Shortages — Risk or Reality?" Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 138, no. 1 (February 2005): 27–30. http://dx.doi.org/10.1177/171516350513800105.

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Background: There has been growing concern about possible drug shortages in Canada, yet we know little about the frequency and impact of shortages in community pharmacies. Objective: The objective of this survey was to determine the extent of any drug shortages in Canadian community pharmacies and the implications of these shortages for community pharmacists. Methods: Surveys and log sheets were faxed to a random sample of 1000 Canadian community pharmacists. Results: More than half of the pharmacists experienced a shortage during one shift, and 80% experienced drug shortages over a one-week period. The three main reasons given for shortages were manufacturing problems, cross-border drug trade, and raw material shortages. The drug products that were most frequently in short supply were Chronovera, Loestrin, Sodium Sulamyd eye drops, and Minestrin. Pharmacists estimated that they spent an average of 17.5 minutes each shift dealing with drug shortages. Conclusion: Most pharmacists are experiencing shortages and feel that these shortages have become more frequent over the past year. There are a variety of factors that contribute to drug shortages and, while the amount of time spent dealing with them is manageable at the present time, increases in shortages will further stress the system.

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Butterfield, Lindsay, Jared Cash, and Kathy Pham. "Drug Shortages and Implications for Pediatric Patients." Journal of Pediatric Pharmacology and Therapeutics 20, no. 2 (April 1, 2015): 149–52. http://dx.doi.org/10.5863/1551-6776-20.2.149.

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Drug shortages in the United States continue to be a significant problem that negatively impacts pediatric patients of all ages. These shortages have been associated with a higher rate of relapse among children with cancer, substitution of less effective agents, and greater risk for short- and long-term toxicity. Effective prevention and management of any drug shortage must include considerations for issues specific to pediatric patients; hence, the Pediatric Pharmacy Advocacy Group (PPAG) strongly supports the effective management of shortages by institutions caring for pediatric patients. Recommendations published by groups such as the American Society of Health-System Pharmacists and the American Society for Parenteral and Enteral Nutrition should be incorporated into drug shortage management policies. PPAG also supports the efforts of the Food and Drug Administration (FDA) to not only address but prevent drug shortages caused by manufacturing and quality problems, delays in production, and discontinuations. Prevention, mitigation, and effective management of drug shortages pose significant challenges that require effective communication; hence, PPAG encourages enhanced and early dialogue between the FDA, pharmaceutical manufacturers, professional organizations, and health care institutions.

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Bauters, Tiene, Barbara OM Claus, Koen Norga, Isabelle Huys, Steven Simoens, and Geneviève Laureys. "Chemotherapy drug shortages in paediatric oncology: A 14-year single-centre experience in Belgium." Journal of Oncology Pharmacy Practice 22, no. 6 (July 9, 2016): 766–70. http://dx.doi.org/10.1177/1078155215610915.

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Shortages of chemotherapy are a growing challenge for the healthcare system. We present the burden of drug shortages of chemotherapeutics in the paediatric hemato-oncology unit of a tertiary care hospital and solutions that were used to manage them. Between January 2001 and December 2014, 54 individual shortages were detected, affecting a total number of 21 different drugs. In total, 4127 shortage days were registered with a mean duration of 196.5 SD ± 144.0 days per individual drug shortage. Methotrexate, doxorubicin and carboplatin had the longest supply disruptions. Solutions to address the problems were purchase of a generic alternative, a change of individual treatment plans, cohorting of patients and import from abroad.

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Emanuel, Ezekiel J., Katie Shuman, Derek Chinn, and Keerthi Gogineni. "Impact of oncology drug shortages." Journal of Clinical Oncology 31, no. 18_suppl (June 20, 2013): CRA6510. http://dx.doi.org/10.1200/jco.2013.31.18_suppl.cra6510.

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CRA6510 Background: Drug shortages of common chemotherapeutics have been reported. What is the prevalence and consequence of these shortages? Methods: Between 9/2012 and 1/2013, a self-administered questionnaire was sent to a random sample of 455 board-certified U.S. oncologists selected from the American Society of Clinical Oncology directory to assess the prevalence of shortages and impact on therapeutic decision-making. 245 responses were received (response rate 55%), of whom 210 were practicing medical oncologists/hematologists. Results: Due to drug shortages in the prior 6 months, 92% (163) of oncologists reported that their patients’ treatment was affected and 83% (174) were unable to prescribe standard chemotherapy. The five chemotherapy agents most commonly reported in shortage were: leucovorin (68%), liposomal doxorubicin (63%), 5-FU (19%), bleomycin (18%), and cytarabine (17%). Physicians adapted in many ways. 38% of the time, oncologists substituted more expensive branded drugs for those in shortage, such as levoleucovorin for leucovorin. Nearly 13% of the time, shortages prevented enrollment, delayed administration of a study drug, or suspended involvement of patients on clinical trials. Despite the prevalence of scarcities, 70% (146) of oncologists reported their cancer centers or practices lacked formal guidance for allocation decisions. Conclusions: Drug shortages in oncology are very common, compromise the delivery of standard care, impede research, and lead to higher costs by using branded drugs instead of generics. Oncologists also seem to lack formal guidance on how to address these shortages. [Table: see text]

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Hudson-Disalle, Sarah, David L. DeRemer, Larry W. Buie, Mark Hamm, Jeffrey Pilz, and Ali McBride. "National survey on the effect of oncology drug shortages in clinical practice: A Hematology Oncology Pharmacy Association (HOPA) survey." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e13609-e13609. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e13609.

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e13609 Background: Drug shortages are a clear and growing challenge. Prominent shortages included oncology medications and supportive care products essential for the care of cancer patients. Oncology drug shortages often result in disruptions in the timing of chemotherapy treatments, alterations in the dose or regimen administered, or even missed doses when alternative agents are unavailable. The purpose of this survey was to characterize the impact of oncology drug shortages across the United States, including the experiences of health care organizations, resource implications, and the impact on patient safety, patient care, and clinical trials. Methods: A 34-item online survey was distributed to HOPA membership of the Hematology Oncology Pharmacy Association to gather information on shortages of oncology drugs (i.e., all drugs essential in the care of cancer patients, including supportive care agents. Results: Sixty-eight organizations completed the survey; almost all completed by pharmacists, and analysis completed. Sixty-three percent of institutions reported one or more drugs shortages a month, with a 34.33% increase in 2019 from 2018. Sixty four percent of responded had incurred increased costs from oncology drugs shortages, with 7% noting reimbursement issues when switched to brand name therapies due to shortages. Treatment delays, reduced doses or alternative regimens were reported by 74.63% of respondents. The most common disease states which causes a dose delay of treatment included Acute Lymphocytic Leukemia, Lymphoma and Multiple Myeloma with dose reductions noted in 36.36%, 36.36 and 15.91%. The top five oncology drugs on shortage included epirubicin, flutamide, decitabine, mechlorethamine, dactinomycin with the top 5 supportive care drugs on shortage being noted as hydrocortisone, bivalirudin, promethazine, mycophenolate sodium and scopolamine. Respondents noted medication errors related to oncology drug shortages at 4.48%, with noted errors including incorrect conversion from iv to oral etoposide and incorrect EMR drug builds. Oncology Drug shortages impacted clinical trials in 13.4% of respondents in which 54.55% of respondents noting patients not being enrolled in clinical trials. Conclusions: A survey of US oncology pharmacists and technicians indicated that oncology drug shortages occurred frequently in 2020. Shortages led to delays in chemotherapy and changes in treatment or omission, complicated clinical research and increased the risk of medication errors and adverse outcomes.

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Kaizer, Leonard, Sherrie Hertz, Lyndee Yeung, Lisa Milgram, Scott Gavura, Ram Iyer, and Monika K. Krzyzanowska. "Managing chemotherapy drug shortages in Ontario." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 192. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.192.

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192 Background: Chemotherapy drug shortages are common and unpredictable. The causes are multifactorial and the negative effects on patients and practitioners have been well described. In an effort to mitigate the impact of this problem, Cancer Care Ontario (CCO) has developed a coordinated approach to the management of chemotherapy drug shortages. Tactics have included a system level strategy to promote communication through a virtual collaborative workspace for providers to network and share management strategies and inventory, where feasible. Disease site experts have also developed clinical guidance for the management of specific drug shortages which have then supported public funding decisions that enabled the use of substitute chemotherapy agents in a number of instances. Methods: The impact and management of a recent shortage of liposomal doxorubicin (LD), a publically funded drug for patients with platinum refractory ovarian cancer is described for both new chemotherapy starts and for prevalent LD treated cases. Expert clinical guidance supported a funding policy amendment so patients already on treatment could switch to a recognized substitute drug, topotecan (TT). This also became the preferred funded option for new platinum refractory patients. Results: LD was in short supply between August 2011 and December 2012. In the quarter prior to shortage, 83 new platinum refractory patients started on LD and 1 on TT. During that time, the average number of monthly prevalent LD and TT treated cases was 80 and 4 respectively. For the first quarter post shortage, 20 new patients started on LD and 34 patients started on TT. The average monthly prevalent treated cases were 49 and 21 respectively. Funding for the switch from LD to TT was requested in only 7 cases. Therefore, the total number of new and prevalent treated cases on either preferred therapy dropped post LD shortage. This decline worsened with each subsequent quarter and immediately returned to baseline when the shortage resolved. Drug procurement costs were lower during the period of shortage. Conclusions: Drug shortages have a significant impact on patients and providers. Even when appropriate substitutes are available, quality of care may be affected.

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Omer, Sumaira, Mengyuan Pan, Salamat Ali, Sundus Shukar, Yu Fang, and Caijun Yang. "Perceptions of pharmacists towards drug shortages in the healthcare system of Pakistan and its impact on patient care: findings from a cross-sectional survey." BMJ Open 11, no. 12 (December 2021): e050196. http://dx.doi.org/10.1136/bmjopen-2021-050196.

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ObjectiveThis study aimed to explore pharmacists’ perceptions on drug shortages and its impingement on the Pakistani healthcare system, in particular on patient care.DesignOnline questionnaire survey.Setting and participantsHospital pharmacists from five out of seven regions of Pakistan were approached; including the federal territory (Islamabad) and four provinces (Khyber Pakhtunkhwa, Balochistan, Punjab and Sindh).Primary and secondary outcome measuresPrevalence and type of shortages were identified along with strategies to reduce its effect on patient care.MethodA validated questionnaire was distributed through various online platforms to 800 registered hospital pharmacists. A convenience sampling technique was used to obtain information on drug shortages, the reporting system for shortages, the impact on patients and policy solutions for managing drug shortages.ResultsOut of 800 hospital pharmacists, 708 completed the questionnaire (response rate: 88.5%). Of these hospital pharmacists, 47% came from hospitals of Punjab, 26% from Khyber Pakhtunkhwa, 13% from Sindh, 11% from Balochistan and 4% from Islamabad; 72% and 28% worked in tertiary and secondary hospitals, respectively. The majority (32%) interacted with shortages daily. The top three drug categories reported in shortage were oncology drugs (54%), cardiovascular drugs (53%) and antimicrobials (42%). 58% of the respondents have seen care delayed as a negative consequence of shortages. ‘Creating new communication system’ (65%) and ‘readjust budget plans’ (41%) were the two most frequently indicated recommendations for shortages management at hospital, while ‘circulars or alerts from the regulatory authority’ (60%) and ‘time to time directives from local health statuaries’ (48%) were two most widely suggested policy solutions.ConclusionDrug shortage is a serious concern in Pakistani hospitals, experienced on a daily basis endangering patients’ health. Enhanced communication is required, connecting the key stakeholders. Health policies should be reviewed; adequate funds should be allocated to the health sector preventing future shortages.

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Rumberger, Russell. "The Shortage of Mathematics and Science Teachers: A Review of the Evidence." Educational Evaluation and Policy Analysis 7, no. 4 (December 1985): 355–69. http://dx.doi.org/10.3102/01623737007004355.

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Many people believe that one major problem currently confronting American education is a severe shortage of mathematics and science teachers. This paper develops alternative ways of measuring shortages and reviews the evidence based on these alternative measures. Evidence from other studies as well as new evidence presented here suggests that shortages do exist, but that they are much Jess severe than previous studies have claimed. In addition, comparisons with earlier studies suggest that shortages of qualified mathematics and science teachers have existed at least since the 1960s. The present analysis reveals that two factors contributing to such shortages are the placement of recent qualified graduates outside of teaching and the misassignment of certified graduates who go into teaching.

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Beck, Matthias, and Joan Buckley. "Managing pharmaceutical shortages during the COVID pandemic: An exploratory analysis of European collective and national government responses." Journal of Medicine Access 6 (January 2022): 275508342211234. http://dx.doi.org/10.1177/27550834221123425.

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Prior to the outbreak of the COVID pandemic, pharmaceutical shortages were already recognised as a major policy problem by most, if not all, European governments; and virtually all European national governments today publicise official shortage lists. Policy making in the area has been centred on the national government level, which meant that the understanding, definition, and response to shortages has remained highly heterogeneous. When the advent of the COVID pandemic exacerbated shortages, this situation continued against a background of a weak collective European response. As part of their responses to COVID-shortages, the medicines regulators of European countries expanded the range of products pharmacies could manufacture, process and distribute as well as their procedural authority in issuing, handling and processing prescriptions. While these measures were fairly common across Europe and alleviated some bottlenecks or improved medicine access for some patient groups, other responses were highly individualistic and included export bans of certain medications as well as efforts to draw on veterinary supplies. Our own data analysis of officially recorded shortage data during the first COVID wave (to October 2020) indicates that countries that had prepared for these types of crisis and maintained an active policy stance (e.g. Germany and Norway) were more likely to encounter fewer shortages than others. We also note that there is no direct correlation between officially recorded numbers of shortages and the ways in which national governments responded to these – which indicates that cultural expectations also might have been a significant policy driver.

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Benhabib, Amine, Saïd Ioughlissen, Christelle Ratignier-Carbonneil, and Patrick Maison. "The French reporting system for drug shortages: description and trends from 2012 to 2018: an observational retrospective study." BMJ Open 10, no. 3 (March 2020): e034033. http://dx.doi.org/10.1136/bmjopen-2019-034033.

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ObjectivesThe aim was to provide figures for drug shortages in France and describe their characteristics, causes and trends between 2012 and 2018.MethodsData from the national reporting system from the Agency of Medicine and Health Product Safety (ANSM) was analysed. This database contains information regarding effective and predicted shortages of major therapeutic of interest drugs (ie, drugs whose shortage would be life-threatening or representing a loss of treatment opportunity for patients with a severe disease) which are mandatory reported by marketing authorisation holders to the ANSM. Data are presented as numbers or percentages of pharmaceutical products (ie, the product name and its formulation) reported on shortage between 2012 and 2018.ResultsThere were 3530 pharmaceutical products reported on shortage during the period, including 1833 different active substances. Drugs on shortage were mostly old products (63.4%) with national marketing authorisation procedures (62.8%), as well as injectable and oral forms (47.5% and 43.3%, respectively). Anti-infectives for systemic use ranked first (18%), followed by nervous and cardiovascular system drugs and by antineoplastic and immunomodulating agents (17.4%, 12.5% and 10.4%, respectively). The number of reported shortages presented a fourfold increase between 2012 and 2018 and a sharp rise in 2017 and 2018, along with a rise in the number of active substances on shortage. The therapeutic classes concerned remained similar over time. Manufacturing and material supply issues were the main reported reasons for the shortage each year (30%) and there was an overall rise of pharmaceutical market reasons.ConclusionDrug shortages were increasingly reported in France. Preventive measures should specifically target the products most on shortage, in particular old drugs, injectable, anti-infective, nervous system and cardiovascular system drugs as well as antineoplastic and immunomodulating agents.

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Jenkins, Liz. "Solving shortages." Nursing Standard 11, no. 1 (September 25, 1996): 14. http://dx.doi.org/10.7748/ns.11.1.14.s30.

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Craig, Marveen. "Sonographer Shortages:." Journal of Diagnostic Medical Sonography 19, no. 4 (July 2003): 261–71. http://dx.doi.org/10.1177/8756479303253946.

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Rethman, Mike. "PERSONNEL SHORTAGES." Journal of the American Dental Association 138, no. 4 (April 2007): 442. http://dx.doi.org/10.14219/jada.archive.2007.0189.

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Batista, Aida, Nenad Miljković, Piera Polidori, and Stephanie Kohl. "Medicines shortages." European Journal of Hospital Pharmacy 26, no. 5 (July 29, 2019): 290–91. http://dx.doi.org/10.1136/ejhpharm-2019-001911.

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Russo, Gene. "Emerging shortages." Nature 462, no. 7271 (November 2009): 375. http://dx.doi.org/10.1038/nj7271-375a.

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Wolinsky, Howard. "Crop shortages." EMBO reports 11, no. 7 (July 2010): 508–10. http://dx.doi.org/10.1038/embor.2010.87.

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Novack, Gary D. "Drug Shortages." Ocular Surface 10, no. 1 (January 2012): 51–54. http://dx.doi.org/10.1016/j.jtos.2011.12.002.

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Waldron, Tony. "Health shortages." New Scientist 217, no. 2901 (January 2013): 33. http://dx.doi.org/10.1016/s0262-4079(13)60241-9.

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Gentle, Robyn. "Nursing shortages." Nursing Standard 31, no. 6 (October 5, 2016): 30. http://dx.doi.org/10.7748/ns.31.6.30.s32.

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Williams, Ruth. "Staffing shortages." Nursing Management 24, no. 8 (November 28, 2017): 11. http://dx.doi.org/10.7748/nm.24.8.11.s11.

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Dutton, Richard P., and Jerry A. Cohen. "Medication Shortages." Anesthesia & Analgesia 113, no. 6 (December 2011): 1298–99. http://dx.doi.org/10.1213/ane.0b013e3182282968.

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Calman, Neil, Diane Hauser, Edward Salsberg, and Gaetano Forte. "Physician Shortages." Health Affairs 22, no. 4 (July 2003): 260–62. http://dx.doi.org/10.1377/hlthaff.22.4.260-a.

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Buchan, J. "Nursing shortages." BMJ 312, no. 7024 (January 20, 1996): 134–35. http://dx.doi.org/10.1136/bmj.312.7024.134.

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Maynard, A. "Nursing shortages." BMJ 312, no. 7038 (April 27, 1996): 1102. http://dx.doi.org/10.1136/bmj.312.7038.1102b.

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Wallace, P. G. M., P. G. Lawler, and J. Wardrope. "Bed shortages." BMJ 314, no. 7077 (February 1, 1997): 369. http://dx.doi.org/10.1136/bmj.314.7077.369.

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Knebel, Pat. "Personnel Shortages." Laboratory Medicine 38, no. 8 (August 1, 2007): 506. http://dx.doi.org/10.1309/9kg0k5039h5xpmpr.

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Crosby, Mark. "Personnel Shortages." Laboratory Medicine 38, no. 8 (August 1, 2007): 506. http://dx.doi.org/10.1093/labmed/38.8.506a.

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Meadows, J. Allen, David B. K. Golden, James Tracy, Erika Gonzalez Reyes, and James Sublett. "Venom shortages." Annals of Allergy, Asthma & Immunology 123, no. 2 (August 2019): 131–32. http://dx.doi.org/10.1016/j.anai.2019.03.001.

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Meadows, J. Allen, David B. K. Golden, James Tracy, Erika Gonzalez Reyes, and James Sublett. "Venom shortages." Annals of Allergy, Asthma & Immunology 123, no. 1 (July 2019): 9–10. http://dx.doi.org/10.1016/j.anai.2019.03.006.

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Mitka, Mike. "Drug Shortages." JAMA 306, no. 18 (November 9, 2011): 1970. http://dx.doi.org/10.1001/jama.2011.1602.

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Bleich, Dirk, and Andreas Dombret. "Financial System Leverage and the Shortage of Safe Assets: Exploring the Policy Options." German Economic Review 16, no. 2 (May 1, 2015): 161–80. http://dx.doi.org/10.1111/geer.12049.

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Abstract In this article, we provide a simple supply and demand framework in which the build-up of an excessive level of leverage can result in a shortage of safe assets. On the basis of this, we discuss various policy options. First, we address the question of what policy-makers should do if shortages of safe assets arise. Second, we discuss what has to be done to prevent potential shortages of safe assets. Our main finding is that a smoother leverage cycle - which, in particular, implies less leverage in booms - is a major condition for preventing shortages of safe assets.

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Liu, Ina, Evan Colmenares, Casey Tak, Mary-Haston Vest, Henry Clark, Maryann Oertel, and Ashley Pappas. "Development and validation of a predictive model to predict and manage drug shortages." American Journal of Health-System Pharmacy 78, no. 14 (April 4, 2021): 1309–16. http://dx.doi.org/10.1093/ajhp/zxab152.

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Abstract Purpose Pharmacy departments across the country are problem-solving the growing issue of drug shortages. We aim to change the drug shortage management strategy from a reactive process to a more proactive approach using predictive data analytics. By doing so, we can drive our decision-making to more efficiently manage drug shortages. Methods Internal purchasing, formulary, and drug shortage data were reviewed to identify drugs subject to a high shortage risk (“shortage drugs”) or not subject to a high shortage risk (“nonshortage drugs”). Potential candidate predictors of drug shortage risk were collected from previous literature. The dataset was trained and tested using 2 methods, including k-fold cross-validation and a 70/30 partition into a training dataset and a testing dataset, respectively. Results A total of 1,517 shortage and nonshortage drugs were included. The following candidate predictors were used to build the dataset: dosage form, therapeutic class, controlled substance schedule (Schedule II or Schedules III-V), orphan drug status, generic versus branded status, and number of manufacturers. Predictors that positively predicted shortages included classification of drugs as intravenous-only, both oral and intravenous, antimicrobials, analgesics, electrolytes, anesthetics, and cardiovascular agents. Predictors that negatively predicted a shortage included classification as an oral-only agent, branded-only agent, antipsychotic, Schedule II agent, or orphan drug, as well as the total number of manufacturers. The calculated sensitivity was 0.71; the specificity, 0.93; the accuracy, 0.87; and the C statistic, 0.93. Conclusion The study demonstrated the use of predictive analytics to create a drug shortage model using drug characteristics and manufacturing variables.

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Huat See, Beng. "Where have we gone wrong in our battle against teacher shortages?" Open Access Government 36, no. 1 (October 5, 2022): 252–53. http://dx.doi.org/10.56367/oag-036-10380.

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Where have we gone wrong in our battle against teacher shortages? Beng Huat See from the Durham Evidence Centre for Education, Durham University, looks at the chronic issue of teachers shortages and how to fix it. The issue of teacher shortages is a global one. According to the recent Eurydice report (European Commis- sion/EACEA/Eurydice 2021), 35 of the 43 education systems across Europe reported a shortage of teachers. Beng Huat Sees research combines the analysis of policy decisions, longitudinal time series analysis of data on teacher numbers and teacher vacancies, and a national survey of undergraduates and robust evaluations of policy interventions.

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SICILIA, JOAQUÍN, JAIME FEBLES-ACOSTA, and MANUEL GONZÁLEZ-DE LA ROSA. "DETERMINISTIC INVENTORY SYSTEMS WITH POWER DEMAND PATTERN." Asia-Pacific Journal of Operational Research 29, no. 05 (October 2012): 1250025. http://dx.doi.org/10.1142/s021759591250025x.

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This paper presents a detailed analysis of inventory systems in which the demand for inventory is deterministic, varies by time in each order cycle, and follows a power pattern. Shortages are allowed. The decision variables are the initial stock level and the scheduling period. Holding cost, shortage cost, and replenishment cost are considered. Several scenarios are studied. First, the inventory system without shortages is analyzed, followed by systems with shortages. The full backordering and the completely lost sales systems are discussed and the optimal policy for each is explicitly determined. Several numerical examples are provided to illustrate the efficient inventory policy and the minimum cost for each inventory system.

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McHenry-Sorber, Erin, and Matthew P. Campbell. "Teacher shortage as a local phenomenon: District leader sensemaking, responses, and implications for policy." education policy analysis archives 27 (July 29, 2019): 87. http://dx.doi.org/10.14507/epaa.27.4413.

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While the teacher shortage is a national crisis, the manifestations of the shortage are felt most acutely at the local district level. The diversity of these micro-contexts often leads to disparities in the ways local school systems are served by large-scale initiatives. District leaders provide an important lens for understanding the localized manifestation of teacher shortages. This research contributes to the existing macro-level literature on teacher shortages through investigation of the ways in which district leaders in West Virginia make sense of and respond to the teacher shortage. As part of a broader study, we share analyses of interviews with seven district leaders across five county school districts and highlight the ways in which leaders made sense of the phenomenon in paradoxical ways, both in terms of the most salient causes as well as the perceived locus of control in addressing the teacher shortage. Findings also highlight the way district leader sensemaking led to action, with responses differing based on relative affordances of metropolitan versus rural contexts. We conclude with implications for policy and research to further understand the local nature of teacher shortages and to address the problem, particularly in rural contexts underserved by current research and policy.

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Poswal, Preety, Anand Chauhan, Yogendra Rajoria, Rahul Boadh, and Abhinav Goel. "Fuzzy optimization model of two parameter Weibull deteriorating rate with quadratic demand and variable holding cost under allowable shortages." Yugoslav Journal of Operations Research 32, no. 4 (2022): 453–70. http://dx.doi.org/10.2298/yjor220115021p.

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In this paper, a fuzzy inventory model with a Weibull deterioration rate, a quadratic demand rate, and a variable holding cost under permissible shortages has been developed. The deterioration rate is expressed by a two-parameter Weibull distribution. During a shortage, some buyers wait for the actual product, while others do not. This shortfall is considered partially backlogged in this model. Some buyers wait for the actual product during such shortages, but many do not. Therefore, partially backlogged shortages are taken into account in this approach. In a traditional inventory model, all parameters such as purchasing cost, shortage cost, holding cost, etc. are predetermined. However, there will be some variations. As a result, fuzzy factors are more accurate to deal with the real world?s problems. This research attempts to cut down the cost in a fuzzy environment by using quadratic demand, shortage, Weibull deterioration rate, and variable holding cost. Costs such as ordering, shortage, and deterioration are addressed as pentagonal fuzzy numbers that are defuzzified using a graded mean representation approach. Finally, sensitivity analysis was carried out to investigate the influence of cost parameters on total inventory cost. A numerical example is used to validate the proposed model in a real-world system.

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McCarthy, Daniel. "The Virtual Health Economy: Telemedicine and the Supply of Primary Care Physicians in Rural America." American Journal of Law & Medicine 21, no. 1 (1995): 111–30. http://dx.doi.org/10.1017/s0098858800010224.

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For years, people living in rural areas have struggled unsuccessfully to attract and retain primary care physicians to supply basic medical care to their residents. Rural areas continue to suffer from chronic shortages of physicians and mid-level practitioners, as well as high rates of hospital closures and increased levels of uninsurance and underinsurance, reducing both the physical and financial health of these communities. Physical and economic barriers unique to rural areas block the adequate delivery of health care and contribute to this shortage of health care personnel.Although Congress has made some progress in identifying where health care shortages occur, it has not adequately identified the source of the shortages, and thus, it has not been able to find adequate solutions to rural health care ills. Past legislative action has involved identifying shortage areas and then providing financial incentives to attract physicians and increase the financial health of hospitals by subsidizing the difference between rural America's ability to pay and what physicians are willing to accept.

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