Canadian Pharmacists Journal / Revue des Pharmaciens du Canada

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.

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.

Surveys and log sheets were faxed to a random sample of 1000 Canadian community pharmacists.

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.

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.

The objective of this study was to evaluate whether increasing patient, nurse, and family physician awareness about osteoporosis had an effect on post-discharge initiation of osteoporosis treatment after fragility fracture. A recent study had found that less than 20% of patients with osteoporosis who were treated in hospital for bone fracture received subsequent investigation and treatment of their osteoporosis.

The subjects consisted of a historical cohort of 33 patients and a prospective intervention group of 33 patients admitted to a community hospital with a diagnosis of fragility fracture. Data were analyzed for 28 patients in the historical control group and 27 patients in the intervention group. All patients in the latter group gave verbal consent to discuss risk factors and treatment options for osteoporosis. Subjects were included if they were at least 50 years of age and had been admitted to hospital because of hip, wrist, or ankle fracture. Patients were excluded if they had traumatic fractures or fractures related to cancer and if they had dementia or Alzheimer's disease. Patients in the intervention group received education from the pharmacist about osteoporosis. Patients in both groups received a follow-up phone assessment six months after the initial hospital admission. The main outcome measures were number of patients who received bone mineral density (BMD) tests and the number for whom osteoporosis treatment was initiated.

No significant difference was observed between the groups in terms of the number of BMD tests ordered (p = 0.49), however, significantly more patients in the pharmacist intervention group had started treatment for osteoporosis at six months after the fragility fracture (p = 0.001).

When pharmacists provided education about osteoporosis to patients and nurses and provided information about osteoporosis to family physicians, the proportion of patients receiving treatment for osteoporosis after a fragility fracture was significantly greater than when such information was not provided.