Shortages of clinical nutritional components and management strategies

Abstract

Parenteral nutrition (PN) solution is a medication of high concern due to its intricate drug utilization procedure. It has been reported that since 2010, nearly every component involved in the preparation of PN admixtures has experienced a shortage at least once. Shortages may lead to therapy delays in hospitals, clinics and other health-related facilities or reductions in quality, prompting healthcare providers to recommend alternative treatments, potentially leading to medication errors, negatively influencing patient outcomes, and consume healthcare assets. The causes of medication shortages are diverse and encompass unidentified factors (44%), manufacturing complications (36%), supply and demand imbalances (8%), discontinued product lines (8%), insufficient access to raw materials (4%), and natural disasters. The duration for the resolution of these shortages was inconsistent, with certain product shortages that were resolved experiencing a recurrence, while others persisted for several months to years. The pharmacy department can take the lead in efficiently managing drug shortages by guaranteeing that its institution possesses the essential infrastructure and a clearly outlined management strategy well in advance of any shortages arising. During periods of shortages, it is extremely important to limit the use of nutritional products to patients with valid indications and those with nonfunctional gastrointestinal systems. Effective management of drug shortages, including PN components, necessitates a comprehensive plan and the involvement of an interprofessional team. This team should contribute to the development of the plan and be ready to implement it swiftly in case of a shortage or outage. Once the shortage of PN components is deemed resolved, all rationing and conservation strategies should be halted, as these measures are meant to be employed exclusively during shortages. Once the PN component shortage has been resolved, it is crucial to resume providing the full dosage of PN components to all patients in need of PN therapy.