Accessibility of unavailable medication

Abstract

Accessibility and availability to adequate treatment always impacted public health, especially in the aftermath of geopolitical and pandemic exigencies. This research aims to establish an evidence-based framework that provides a rational and prompt medicine accessibility strategy based on availability while meeting the needs of the patients. The research design involved two phases, a retrospective quantitative analysis of medicinal sales over the previous decade from within the Mater Dei Hospital (MDH). A trend and statistical analysis were carried out for each medication. Graphs and statistical results generated allowed the identification of positive and negative correlations across the data collected. It was subsequently distinguished that the ten most requested statistically significant medications exhibited the highest positive correlation coefficients across the duration of data collected. These preparations are potassium bicarbonate and chloride effervescent tablets, phenobarbital sodium 30mg tablets, propranolol 10mg, cyclizine 50mg, labetalol 200mg, acetazolamide 250mg tablets, propranolol 10mg, nifedipine 10mg modified release tablets, pentoxifylline 400mg tablets, iron preparation syrup and metoprolol 100mg tablets. Additionally, data collected also provided the opportunity to identify medications with a negative correlation. Notably, clozapine 100mg tablets and methylphenidate 10mg tablets exhibited the strongest negative correlations. The second phase related to the thematic analysis of data gathered across focus groups from healthcare professionals representing different specialities or fields. Each focus group represented the surgical, medical, intensive care, operating theatre and pharmacy settings within the MDH. Data collected identified six main challenges encountered across the listed clinical areas affecting the accessibility and availability aspects of medications. Primarily acknowledging the need for communication and collaboration across all stakeholders. Additionally, the data collected aided in developing a local evidence-based framework to safeguard treatment accessibility while maintaining an updated healthcare aspect. The framework captures operational and therapeutic assessments to aid in the prior identification of drug shortages and mitigation strategies. Framework also integrates an impact analysis, capturing the importance of the identification and logistical processes associated with ensuring the availability and accessibility of appropriate medication. The importance of constant communication among all stakeholders for the implementation and prevention of drug shortages is highlighted. In conclusion, this study identified frequent medications requested from the MDH pharmacy from within the community. The findings provide an opportunity to increase the accessibility and availability of medicines to the local community by private community pharmacy suppliers.