Variability in compounding of oral liquids for pediatric patients: A patient safety concern

• Published in: Journal of the American Pharmacists Association Vol. 54; no. 4; pp. 383 - 389
• Main Authors: Rood, Janis M., PharmD, Engels, Melanie J., PharmD, Ciarkowski, Scott L., PharmD, MBA, Wagenknecht, Larry D., BSPharm, Dickinson, Chris J., MD, Stevenson, James G., PharmD, FASHP
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2014
• Subjects: Administration, Oral; Community Pharmacy Services; Cross-Sectional Studies; current pharmacy practicesformulations; drug compounding; Drug Compounding - adverse effects; formulations; Humans; Internal Medicine; Medication Errors; Michigan; oral liquids; Patient Safety; Pediatrics; Pharmaceutical Services; Pharmaceutical Solutions - chemistry; Pharmaceutical Solutions - therapeutic use; Pharmacies; Pharmacists; Michigan; Patient safety; current pharmacy practicesformulations; formulations; drug compounding; oral liquids; pediatrics
• ISSN: 1544-3191; 1544-3450
• DOI: 10.1331/JAPhA.2014.13074

Abstract Objective To determine the degree in variation of oral liquid pediatric compounding practices in Michigan pharmacies. Design Cross-sectional survey study. Setting All types of inpatient and outpatient pharmacies across the state of Michigan, excluding nuclear pharmacies and long-term care facilities. Participants 244 Michigan pharmacies. Intervention An online survey tool was used to assess the current compounding practices of 147 oral liquid pediatric medications. The survey was e-mailed or faxed to hospitals, chain pharmacies, and independent pharmacies. Pharmacists were also mailed a follow-up postcard, and the Michigan Pharmacists Association publicized the project through its journal and annual meeting. Main outcome measures Pharmacy demographics; number of compounding pharmacies; number of medications compounded; awareness of compounding errors; results of compounding errors; and number of concentrations compounded per medication. Results The majority of respondents were from outpatient pharmacies, but inpatient and other types of pharmacies were also represented. The majority of participating pharmacies compound fewer than five oral liquid medications per week. Awareness of errors was low overall, with no errors believed to result in permanent harm or death. The number of concentrations compounded per medication ranged from 1 to 9, with the majority of pharmacies compounding more than 3 concentrations per medication. Conclusion There is a considerable degree of variation in current oral pediatric liquid compounding practices in Michigan pharmacies. This variability poses a significant risk to patient safety.