The Current Landscape of Veterinary Compounding in the Pharmacy Setting

Abstract

Medicating animals poses unique challenges that are often best dealt with via compounding. Pharmacists receive compounding training while in pharmacy school, but this training is not veterinary specific. Pharmacists are expected to have enough knowledge to properly verify prescriptions that are received at their practice site while keeping with the most up-to-date guidelines related to animal and human health. Whether pharmacists have the proper training to verify and/or compound veterinary specific medications is unknown. A self-administered survey was distributed electronically to 4,550 email addresses on record with the American College of Veterinary Pharmacists, the International Academy of Compounding Pharmacists, and the Society of Veterinary Hospital Pharmacists. The survey asked questions about regulations and standards associated with the use of prescription or compounded medications. Of the 4,550 distributed surveys, 153 were received, for a 3.4% response rate. Of the responses received, only 131 were used in the final data analysis. Most respondents correctly answered the assessment question regarding the ability to compound backordered, commercially available products. A majority of respondents incorrectly answered the question regarding the proper flavoring for a medication for a ferret. Those with more training perceived themselves to have a higher level of skill (r = 0.41, P<0.001). Similarly, those with formal veterinary training had better scores on Question 4 of the assessment questions, which requires knowledge of feline toxicities (P=0.029). The most common compounded medications dispensed in practice by pharmacists are methimazole, metronidazole, and gabapentin. Pharmacists mostly recognized that compounding backordered, commercially available products is permitted. Formal training improves familiarity with current compounding rules, regulations, and best practices. Formal training in veterinary pharmacy and veterinary compounding should be promoted and encouraged. Efforts should also be made at improving pharmacists' understanding of both veterinary and compounding laws and regulations.