Évaluation des impacts organisationnels et cliniques des ruptures de médicaments au sein d’un Centre Hospitalier Universitaire

Drug supply problems are a real public health concern. Despite the implementation of legal measures, this problem is still relevant, with potential clinical, organizational and financial consequences in hospitals. The objective is to evaluate the organizational and clinical impact of supply problems in a hospital. A retrospective study of the supply problems encountered in our institution made it possible to classify them according to different criteria using an algorithm. A mapping of the organizational impact of the resolution of each supply problem according to the internal organization of the medication circuit was developed. The potential clinical impact of each problem identified was assessed using a 4-level scale. Over an 18-month period, 332 supply problems were recorded, 78 % of which were classified as a stock-outs. Over the entire study, 2415 organizational impact points were identified, with 2019 impacts for the pharmacy department and 396 impacts for the healthcare departments. Approximately 90 % of the drugs with a supply problem were drugs of major therapeutic interest. In 49 % of the situations, they have a lesser clinical impact as soon as shortage management is put in place. The characterization of the different management methods has made it possible to systematically identify and predict the impact on the entire medication circuit. The impact on the patient is thus limited if the management of the supply problem is well anticipated by the pharmacist. The pharmacist plays an important role in managing supply problems, but also in providing support to the care services.