A cross-sectional evaluation of medicine shortages in community pharmacy: implications for patients, pharmacists and clinical service expansion

Background Community pharmacists play a pivotal role in managing medicine shortages (MSs) internationally. Ireland presents an interesting case study to assess the impact of MSs in community pharmacy, owing in part to its small market size. Objectives Accordingly, this study aimed to explore Irish pharmacists' perceptions of MSs, their causes and impact on staff, and patients. A further aim was to investigate their impact on newly introduced clinical pharmacy services. Method Study design utilised a cross-sectional questionnaire comprising multiple choice, Likert-scale and open text questions, disseminated to community pharmacists. Responses were coded and analysed quantitatively using descriptive and inferential statistics. Open-text responses were analysed using reflective thematic analysis. Results Data were collected from 270 pharmacists (6.5% response rate). Over 70% (71.1%, n = 192) perceived an increase in MSs over the past year. Commonly reported causes of MSs were manufacturer allocations (69.8%, n = 185) and manufacturing disruptions (66.4%, n = 176). Impacts of MSs on staff included increased administrative duties (94.8%, n = 238) and work-related stress (97.0% ( n = 260). Pharmacists reported a median of four hours per week spent addressing MSs (IQR 4.0, n = 236). Almost two thirds believed patient health outcomes had been negatively affected (62.8%, n = 169). Patient impacts included treatment interruptions (82.8%, n = 140) and distress and inconvenience (97.6%, n = 165). Regarding clinical services, almost half of respondents (46.3%, n = 124) indicated prescribing challenges due to MSs. Open text comments revealed recommendations for improved communication and collaboration. Conclusion Proactive collaboration among stakeholders is essential to alleviate pressures in managing MSs, improve patient care and support clinical role expansion.