Management of the Covid-19 Health Crisis: A Survey in Swiss Hospital Pharmacies

Background The COVID-19 pandemic has put a lot of strain on health systems since 2020. A review of the Swiss hospital pharmacies responses during the first wave was performed to improve the quality of the pharmaceutical management of future health crises. Methods An electronic survey was sent to all head of hospital pharmacies in Switzerland. The questionnaire was organized into eleven clusters of questions and covered many topics regarding the management of the first wave of COVID-19. Data collection was conducted from May to June, 2020. Results Analyses were performed with 43 responses (66%) out of 65 questionnaires sent (at least one answer per questionnaire). 41% (17/41) of pharmacies had existing standard operating procedures or pandemic plans and 95% of them (39/41) created a steering committee to manage the crisis. 67% (29/43) created new activities to respond to the specific needs of the crisis. 67% (26/39) created new drug lists for: COVID-19-specific treatments (85% of pharmacies; 22/26), sedatives (81%; 21/26), anaesthetics (77%; 20/26) and antibiotics (73%; 19/26). Drug availability in COVID-19 wards was managed by increasing existing stocks (54% of pharmacies; 22/41) and creating extra storage space (51%; 21/41). Two drugs generated the most concern about shortages: propofol (49% of pharmacies; 19/39) and midazolam (44%; 17/39). Remdesivir stocks even ran out in 26% of pharmacies (10/39). Specific new documents were drafted to respond to medical needs with regards to drug administration (28% of pharmacies; 12/43), drug preparation (28%; 12/43) and treatment choices (23%; 10/43). Conclusions Swiss hospital pharmacies encountered many challenges related to the COVID-19 crisis and had to find solutions quickly, effectively and safely. The survey highlights the key role played by Hospital Pharmacy’s in many aspects during the pandemic by providing logistical and clinical support to medical and care teams. The lessons and experiences outlined could be used to improve the quality of the preparation for similar future events. KEY POINTS ### Competing Interest Statement The authors have declared no potential conflicts of interest. ### Funding Statement This study was funded by the Swiss Federal Department of Defence, Civil Protection and Sport, through the Centre of Competence for Military and Disaster Medicine. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The research protocol, which did not imply patient data collection, has been presented to the Cantonal Research Ethics Committee Geneva, which waived an ethical oversight. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Raw data of the survey would be provided upon request * COVID-19 : Coronavirus disease 2019 EpidA : Swiss Federal Act on Epidemics F : French-speaking region of Switzerland G : German-speaking region of Switzerland GSASA : Swiss Society of Public Health Administration and Hospital Pharmacists I : Italian-speaking region of Switzerland ICU : Intensive Care Unit MERS-CoV : Middle East respiratory syndrome coronavirus R : Romansh-speaking region of Switzerland SARS-CoV-1 : Severe acute respiratory syndrome coronavirus 1 SARS-CoV-2 : Severe acute respiratory syndrome coronavirus 2 Swissmedic : Swiss Agency for Therapeutic Products WHO : World Health Organisation