University Report: Evidence-Based Practice and Drug/Supply Shortages

This report delves into the critical issue of drug and medical supply shortages, a prevalent problem globally, analyzed through the lens of evidence-based practice. The study focuses on the impact of these shortages, highlighting adverse patient outcomes and the need for immediate interventions. The research utilizes randomized control trials to evaluate the effects of drug shortages and root cause analysis to identify the underlying issues, such as high drug prices and manufacturing inefficiencies. The report examines the economic, environmental, and humanistic effects of drug shortages, drawing on studies from various countries and revealing the prevalence of shortages across different medication categories, including oncology and antimicrobials. The conclusion emphasizes the importance of collaborative efforts, including the World Health Organization, to address these challenges and improve patient care.

Running head: EVIDENCE BASED PRACTICE
Drug and Medical Supply Shortage
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EVIDENCE BASED PRACTICE
Evidence Based Practice
Evidence-based practices are a conscientious, problem-solving method to clinical settings
that encompasses best evidence from well-designed analyses and patient values and priorities.
There is sadly no basic formula on how far the clinical decision-making process will consider
certain considerations. Nonetheless, a number of rating systems and hierarchies show that the
strength or accuracy of evidence produced by a research study or survey is evaluated. Being
mindful of evidence-based treatment and evidence standards is crucial for every clinician,
because clinicians must be sure how deeply they can inform their decisions about a research,
survey, practice warning or recommendation on clinical practice.
Quality and Safety Issue Topic: Shortage of Drug and Medical Supply
The concern at quality and safety covered in the Article is based on drugs and medical
supply shortages. In the past years, in nations of all levels of income, shortages of drugs and
vaccines have been documented. Shortages can result from one or several causes, such as raw
material shortages, manufacturing capabilities issues, industry consolidation, business practices
and supply chain management and procurement. Recent solutions to reducing shortage involve
early warning services operated by the regulatory agencies of pharmacy, medicines tracking
specialized programs and medicines supply chain improvement strategies. Public redeployment
of resources will mitigate some short-term constraints. Under limited circumstances, it may be
necessary to use an external exchange and extraordinary regulatory approval to recognize that
these strategies are complicated and may pose costs and efficiency threats. If a lack of
medication has to be prioritized, evidence-based research should be used to provide for the best
recognition. Importants are the recognition and effect of most dangerous drugs, the creation of

EVIDENCE BASED PRACTICE
monitoring mechanisms to share information on existing and potential deficiencies, and changes
to evidence from the medical supply chains (LoBiondo-Wood, & Haber., 2017).
In 2013, in Kerala, India the State Essential Medicine List and Rationalized Medication
List was faced with a shortage of 130 drugs since suppliers did not answer to state tenders. With
reasons, ranging from manufacturing issues to poor commercial interest, surgery, injection
medication and in North America psychiatric drugs are still in short supply was the major issue.
BCG vaccination has been in inadequate multi-market since 2012 because of production quality
issues combined with high competition, both important in childhood immunisation and in the
diagnosis of bladder cancer (Iyengar et al., 2016).
Randomized Control Trial as Evidence Based Practice
A total of 230 unique article were found and reviewed following the initial search
according to a survey. 40 manuscripts were included in the final review following the application
of the inclusion and exclusion criteria. All these 40 studies provided evidence on the economic,
environmental and/or humanistic effects on patients health care of drug shortages. The
manuscripts used included from 11 countries all over the world. The majority of manuscripts
were from North America (n= 28), then the rest were from Saudi Arabia in Middle East,
followed by Africa (n= 5), Europe (n= 3), and the West Pacific (n= 3). All manuscripts were
analytical and hence retrospective (n= 19) and surveyed (n= 15). Studies collected patient
imaging (n=21), medical reporting (n=19) and patient reporting (n=3). Some studies have used
multimodal techniques to collect patient results because of scarcity of prominent articles (Phuong
et al., 2019)..

EVIDENCE BASED PRACTICE
19 studies have shown that there are critical drug shortage out of those 15 are unique
medicines. Three medicines have been reported on several occasions: moronobicine (n= 2),
tazobactam piperacillin (n= 2) and propofol (n= 3). Thirteen studies reported a group of
medicines, including seven individual groups. Oncology medicines (n= 6), antimicrobials (n= 2)
are the most common groups. Anesthetics, antihypertense agents, antirretrovirals, pediatrics and
glaucoma drugs were present in the following groups. Eight studies have not shown any specific
drug in shortage, but have shown general drug shortages (Phuong et al., 2019).
Five reports have recorded economic results related to medication shortages. Patient out-
of-pocket (OOP) expenses have been the only economic results reported. The patient OOP costs
were higher in all five studies. 38 studies have disclosed adverse results due to drug scarcity. In
16 studies, mortality has been reported. Of these, 10 reported increased deaths and five reported
equivalent deaths. In eight studies, patient objections have been reported in three studies due to
shortages and four studies have shown increased travel time (Shah et al., 2015). Patients were
annoyed, irritated and felt as though they were a liability and caregivers were another results
reported.
Conclusion
These randomized control trial method of evidence-based practice revealed that drug and
medical shortages prevailed all over the world and hence shoot for immediate interventions by
seeking help from the world health organization. Root cause analysis also stated that these
shortages are mainly due to overwhelming price of critical drugs and inefficiency of the
manufacturers to produce them due to lack of raw materials, which were too costly.

EVIDENCE BASED PRACTICE
References
Iyengar, S., Hedman, L., Forte, G., & Hill, S. (2016). Medicine shortages: a commentary on
causes and mitigation strategies. BMC medicine, 14(1), 124. doi:10.1186/s12916-016-
0674-7
LoBiondo-Wood, G., & Haber, J. (2017). Nursing research-E-book: methods and critical
appraisal for evidence-based practice. Elsevier Health Sciences.
Phuong, J. M., Penm, J., Chaar, B., Oldfield, L. D., & Moles, R. (2019). The impacts of
medication shortages on patient outcomes: A scoping review. PloS one, 14(5), e0215837.
doi:10.1371/journal.pone.0215837
Shah, S., Theodossiades, J., Chapman, K., & Murdoch, I. (2015). Impact of supply problems of
preservative‐free glaucoma medications on patients and hospital staff. Ophthalmic and
Physiological Optics, 35(2), 236-241.