Using Interdisciplinary Teams to Mitigate the Effects of Drug Shortages in Palliative Care: The Case of Lorazepam Injection.

IF 0.9 Q3 ANESTHESIOLOGY
Natalie Hartung, Zainab Fatima, Danielle M Noreika, J Brian Cassel, Katie S Adams
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Abstract

Given the rising frequency of drug shortages in hospitals, interdisciplinary collaboration is necessary to manage medications, modify electronic medical records, and evaluate safety outcomes. One such shortage impacted lorazepam injection, a medication commonly used in palliative care to treat anxiety, agitation, and seizures. In anticipation of the lorazepam shortage in the summer of 2022, pharmacy staff collaborated with palliative care physicians to identify alternative treatment recommendations when providers were prohibited from ordering lorazepam injection. Before the shortage, lorazepam was used an average of 95 times per month on the palliative care unit. The overall use of benzodiazepines decreased substantially following the recommendation for the therapeutic alternative, midazolam, during the shortage. Once the shortage ended, use roughly returned to pre-shortage baselines. During this time, there were no patient safety events documented on the palliative care unit. Moreover, no changes to the care experience were reported by patients, family/caregivers, providers, or staff. The collaborative effort between pharmacy and palliative care specialists resulted in alternative treatments for palliative care patients during the drug shortage. This preserved the hospital's supply of lorazepam injection for a patient population with no suitable alternatives while still allowing for management of palliative patients.

使用跨学科团队减轻姑息治疗中药物短缺的影响:以洛拉西泮注射液为例。
鉴于医院药物短缺的频率不断上升,跨学科合作对于管理药物、修改电子医疗记录和评估安全性结果是必要的。其中一种短缺影响了劳拉西泮注射液,这是一种常用于姑息治疗的药物,用于治疗焦虑、烦躁和癫痫。由于预计2022年夏天会出现劳拉西泮短缺,当提供者被禁止订购劳拉西泮注射液时,药房工作人员与姑息治疗医生合作,确定替代治疗建议。在药物短缺之前,劳拉西泮在姑息治疗室平均每月使用95次。在短缺期间,根据治疗替代品咪达唑仑的建议,苯二氮卓类药物的总体使用量大幅下降。一旦短缺结束,使用大致恢复到短缺前的基线。在此期间,姑息治疗室没有记录任何患者安全事件。此外,患者、家人/护理人员、提供者或工作人员未报告护理体验发生变化。药房和姑息治疗专家之间的合作为药物短缺期间的姑息治疗患者提供了替代治疗。这为没有合适替代品的患者群体保留了医院的劳拉西泮注射液供应,同时仍允许对姑息性患者进行管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.60
自引率
9.10%
发文量
40
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