The effect of COVID-19 on oncology pharmacy services: Results of a 3 month long weekly global survey

Introduction:The COVID-19 pandemic has been felt in all areas of health care. We performed a weekly survey amongst the members of the European Society of Oncology Pharmacy (ESOP) to better understand its effects and how they evolved over time. We specifically studied alterations in the care for patients with cancer as well as in the work of oncology pharmacists. Method(s):An online survey was developed by ESOP to compile data about the effects of COVID-19 on the work practices of professionals working in the field of oncology pharmacy. The survey was distributed electronically on a weekly basis from April 6thto June 28th. Result(s):A total of 1146 responses were gathered from respondents in 60 different countries. At any given time point, between 25% and 38% of the respondents had staff infected with COVID-19. In total, 29% of hospital pharmacists reported shortages of drugs necessary for the treatment of COVID-19 patients, and almost 50% also faced shortages of drugs necessary for the treatment of cancer patients. In addition, the majority of hospital pharmacists reported a decrease in planned surgery for oncology patients, as well as a decrease in the amount of chemotherapy preparations. Community pharmacists faced shortages of personal protective equipment in 40% of cases and shortages of drugs in 60%. Conclusion(s):The work of oncology pharmacists both in the clinical setting as well as in the community has been effected profoundly by the COVID-19 pandemic.Copyright © 2021 Lippincott Williams and Wilkins. All rights reserved.

Explainable Machine Learning for Drug Shortage Prediction in a Pandemic Setting

The COVID-19 pandemic poses new challenges on pharmaceutical supply chain including the delays and shortages of resources which lead to product backorders. Backorder is a common supply chain problem for pharmaceutical companies which affects inventory management and customer demand. A product is on backorder when the received quantity from the suppliers is less than the quantity ordered. Knowing when a product will be on backorder can help companies effectively plan their inventories, propose alternative solutions, schedule deliveries, and build trust with their customers. In this paper, we investigate two problems. One is how to use machine learning classifiers to predict product backorders for a pharmaceutical distributor. The second problem we focused on is what are the particular challenges and solutions for such task under a pandemic setting. This backorder dataset is different from existing benchmark backorder datasets with very limited features. We discuss our challenges for this task including empirical data pre-processing, feature engineering and understanding the special definitions of backorder under the pandemic situation. We discuss experimental design for predicting algorithm and comparison metrics, and demonstrate through experiments that decision tree algorithm outperforms other algorithms for our particular task. We show through explainable machine learning approaches how to interpret the prediction results. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Lean Healthcare tools to increase the service level at a Peruvian Maternal and Infant polyclinic

Worldwide, there is an increase in the shortage of medical supplies due to the global health situation Covid-19. Therefore, it is important to implement methodologies that improve and optimize the management of medical supplies from their purchase, storage and distribution process within these centers. In this sense, the aim of this article is to analyze the relationship between logistics management, the level of supply of medical centers and the level of service provided to patients. Based on this, a study is made of a maternal and child polyclinic in the city of Lima, which has an availability level of 83.51%, which does not reflect an optimal level. Consequently, classification tools are implemented using the ABC-VED matrix and the Inventory Control System. Complementing it with the application of Good Storage Practices and Lean tools such as 5S and Standardization of work to conclude the proposal for improvement in the logistics management of this particular medical center. © 2022 ACM.

Improving Safety by Evaluating the Impact of the Supply Chain and Drug Shortages on Health-Systems.

Background: The COVID-19 pandemic has shown how fragile our healthcare supply chain is with product delays, drug shortages, and labor shortages being exacerbated in recent years. Objective: This article reviews current threats to the healthcare supply chain that impact patient safety and highlights potential solutions for the future. Method: A review of the literature was conducted, and important up-to-date resources associated with drug shortages and supply chain were analyzed to build foundational knowledge. Potential supply chain threats and solutions were then explored through further literature analyses. Conclusions: The information provided in this article helps to brief pharmacy leaders on current supply chain issues and solutions that can be integrated throughout the healthcare supply chain in the future.

The pros and cons of reshoring to address the problems of shortages in global pharmaceutical value chains: the case of antibiotics

PurposeAntibiotics shortages have become an increasingly common problem in Europe because of several reasons, including the offshoring of the production of active pharmaceutical ingredients for many of these products to low production cost countries, such as China and India. The problem has deteriorated because of the Covid-19 crisis that has put most global value chains (GVCs) under great stress. This situation has boosted extensive discussions among academics, practitioners and policymakers on possible changes to the configuration of GVCs. This paper aims to focus specifically on antibiotics supply chains from the perspective of a small country (Sweden), and analyse the pros and cons of backshoring and nearshoring alternatives, as a means to reduce drug shortages. Design/methodology/approachThis work adopts a systemic perspective to capture the implications of reshoring for the different stakeholders involved in the antibiotics field. The present meso-analysis, focusing at the industry level, is based on multiple sources of primary data collected between 2014 and 2021, including participation in policy-related projects and interviews with over 100 representatives of key stakeholders in the antibiotics field. FindingsThis paper shows how reshoring can address the problems of drug shortages and reduce availability risk in antibiotics' GVCs. However, the authors show that no simple and best solution exists because both alternatives of reshoring, i.e. backshoring and nearshoring, entail pros and cons for different stakeholders. The authors conclude with implications for policymakers and managers. Research limitations/implicationsThe analysis of pros and cons of both backshoring and nearshoring for various stakeholders offers relevant implications for research on operations and supply management, international business and economics/political science. Originality/valueThis paper looks at reshoring as a policy-driven decision and provides an innovative systemic perspective to analyse the implications for different stakeholders of two reshoring options concerning the antibiotics supply chain.

Household Drug Stockpiling and Panic Buying of Drugs During the COVID-19 Pandemic: A Study From Jordan.

The coronavirus disease that emerged in 2019 (COVID-19) has affected health, societies and economies. Policies that have been imposed by different countries to slow the spread of the disease, including national lockdowns, curfews, border closures and enforcement of social distancing measures have disturbed the drug supply chain and resulted in drug shortages. Uncertainty concerning the pandemic has also led to the panic buying of drugs and the stockpiling of drugs in households, which has amplified the problem. In this cross-sectional study, a self-developed questionnaire was distributed online in order to a) assess the practice of household drug stockpiling prior to the national lockdown in Jordan, b) investigate the factors affecting it and c) measure peoples' knowledge about the consequences of this behaviour. Results from this study show that drug purchasing was reported by 44.3% of the participants and was most common among participants from non-medical backgrounds (336, 75.7%) or those who have chronic diseases (261, 58.8%) and taking chronic supplements (282, 63.5%) regardless of their age, gender, living area or the possession of health insurance. Analgesics and antipyretics were the most frequently purchased drugs (225, 70.5%) and anticipation of their need was the most common reason for purchasing drugs (231, 52.0%). Buyers were also less aware, when compared to non-buyers, that panic buying and drug stockpiling may lead to drug shortages (204, 45.9% vs 325, 58.1%) and that this behaviour can pose a health hazard, especially to children (221, 47.5% vs 342, 61.2%). Our study shows that panic buying of drugs and household drug stockpiling were common in Jordan during the COVID-19 pandemic and this was related to participants' medical knowledge and educational backgrounds. Therefore, educating the general population regarding rational drug use is urgently needed. This is also a compelling case for the development of national guidelines for drug management that target the general population and healthcare personnel, especially pharmacists, to avoid drug shortages during crises.

Cardiovascular drug shortages in Lebanon: a broken heart.

For nearly 3 years now, Lebanon has been assailed by compounded crises. With the economic instability, the coronavirus pandemic, and the explosion of the Beirut Port on August 4, 2020; the fragile Lebanese healthcare system has found itself at massive risk of a catastrophic public health crisis secondary to cardiovascular drug shortages. The time has come for public health authorities to find urgent solutions for this national trajedy that is projected to last for years.

Nationwide Shortage of Albuterol Inhalers and Off-Label Use in COVID-19 Patients.

The surge in COVID-19 cases during the 2020 Spring led to a nationwide shortage of albuterol inhalers. As a new surge has begun, shortages may make it difficult for patients with obstructive lung disease, including children with asthma, to obtain refills. Since there is no evidence that albuterol relieves symptoms in COVID-19 patients with respiratory symptoms not caused by bronchospasm, it is reasonable for clinicians to not prescribe it for COVID-19 patients unless they also have asthma or chronic obstructive pulmonary disease.

Analysis of drug shortages across two countries during pre-pandemic and pandemic times.

BACKGROUND: Drug shortages have a negative impact on individual health outcomes for patients and health care systems more broadly. In recent years, regulatory bodies, such as the Therapeutic Good Administration in Australia, have provided information about an increasing number of drug shortages. It is reported that 90% of medicines in Australia are imported; this leaves Australia vulnerable to international drug shortages. It has been suggested that Australia is heavily reliant on the US as its primary source of medicines. OBJECTIVE(S): To determine whether there are significant trends in the quantity, frequency, and nature of drug shortages between the US and Australia in a pre-pandemic and pandemic climate. METHODS: This study mapped and analyzed drug shortages reported by both the United States Food and Drug Administration (FDA) and the Australian Therapeutic Goods Administration (TGA) in 2019 and 2020. RESULTS: In 2019 (pre-COVID19), only 4% of US drug shortages were reported in Australia; this rose to 7% in 2020. Between 2019 and 2020, the number of US drug shortages increased by 37%, whilst the number of Australian drug shortages increased by 300%. CONCLUSIONS: The Australian pharmaceuticals market is indeed more vulnerable to drug shortages, particularly in the event of a global pandemic such as COVID-19. However, these shortages are not significantly influenced by the US drug market.

Personal protective practices and pharmacy services delivery by community pharmacists during COVID-19 pandemic: Results from a national survey.

INTRODUCTION: Coronavirus disease (COVID19) has adversely affected the delivery of various health services. Little is known about the impact of COVID19 on pharmacy services across the United Kingdom (UK). We surveyed community pharmacists across the UK to understand their protective practices, professional and general well-being, and the delivery of pharmacy services during the COVID19 pandemic. METHODS: Community pharmacists were invited to participate in a cross-sectional survey via the nationwide weekly newsletter of Pharmaceutical Services Negotiating Committee and the local pharmaceutical committees during the second week of May 2020. The survey remained open for 4 weeks. RESULTS: A total of 206 pharmacists responded to the survey with representations from England, Northern Ireland, Scotland, and Wales. The majority of pharmacists (>75% or above) reported an increase in customer traffic to their pharmacy and were asking relevant questions from patients with flu-like symptoms before signposting them to the appropriate care. Most pharmacists (>85%) were maintaining a safe distance of 2 m from customers and 72% were wearing an N95 protective mask and 28% were using protective gloves and apron in addition to safe distancing and protective masks. Ninety-nine percent of pharmacists reported drug shortages with 38% and 26% reported significant drug shortages and critical drug shortages causing disruptions beyond over the counter medicines. Eighty-nine percent pharmacists reported inappropriate behaviour from patients or carers with 31% and 16% reported it to be a regular or frequent problem, respectively. Fifty-three% of pharmacists were willing to offer their assistance for mass testing of COVID19 antibodies if adequate training and reimbursement are provided. CONCLUSION: Community pharmacists in the UK are facing considerable challenges in terms of personal protection and the delivery of pharmacy services. Inappropriate behaviour from patients and carers towards community pharmacists require urgent attention to ensure a safe working place for all community pharmacists.

What Does the COVID-19 Pandemic Mean for Rheumatology Patients?

PURPOSE OF REVIEW: The COVID-19 outbreak has resulted in uncertainty for patients with autoimmune rheumatic diseases for several reasons. They are concerned about their risk of developing COVID-19 as many are immune suppressed from their disease and/or treatment, whether they should stop their advanced therapies, if they will have a worse outcome if/when infected due to their underlying medication condition(s) and if they will have drug availability, especially with press (without much data) coverage suggesting hydroxychloroquine may be used in COVID-19 infection causing diversion of medication supply. This article discusses how the pandemic affects people with systemic autoimmune rheumatic diseases. RECENT FINDINGS: Preliminarily, articles seem to suggest that patients with rheumatic diseases may not have more infections from SARS-CoV-2 and similar outcomes to age and gender matched patients, but fear of rheumatic medications increasing their risk, drug shortages, and work exposure all are concerns for patients. RECENT FINDINGS: The long term effects of the pandemic in patients with rheumatic diseases will not be known until much later and likely include stressors flaring disease (fear, illness, job loss, social isolation), post-traumatic stress, flaring due to stopping medications, less physician visits with subsequent under-treatment, and increases in chronic concomitant fatigue, pain, fibromyalgia.