Perceptions of pharmacists towards drug shortages in the healthcare system of Pakistan and its impact on patient care: findings from a cross-sectional survey

Abstract

Objective: This study aimed to explore pharmacists' perceptions on drug shortages and its impingement on the Pakistani healthcare system, in particular on patient care.

Design: Online questionnaire survey.

Setting and participants: Hospital 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 measures: Prevalence and type of shortages were identified along with strategies to reduce its effect on patient care.

Method: A 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.

Results: Out 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.

Conclusion: Drug 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.

Keywords: general medicine (see internal medicine); health policy; health services administration & management; quality in health care.