MEDICINE’S SHORTAGE: KNOWLEDGE AND PRACTICE OF COMMUNITY PHARMACY STAFF IN PALESTINE

Abstract

Background: The issue of medicine shortages is severe to health care systems globally, especially in areas where political instability and unstable supply chains are in force. Movement restrictions, pharmaceutical importation control, and continuous economic pressures in Palestine limit healthcare delivery and increase the effects of medicine shortages on community pharmacy practice. Objectives: The purpose of the study was to examine the understanding, behaviors of community pharmacy employees in Palestine about medicine shortages, and to understand their perceptions of the causes, effects, and strategies to deal with it. Moreover, it aimed at finding evidence-based solutions to help regulatory authorities reduce future crises. Methods: The descriptive cross-sectional quantitative study with one open-ended question was conducted using a structured self-administered questionnaire that was administered to the staff of the community pharmacies within the Palestinian governorates. Statistically, quantitative data were analyzed by the use of SPSS program, whereas thematic analysis was done with qualitative responses given by open-ended question and validated using NVivo software. Results: The study found that there was a high incidence of medicine shortage in community pharmacies (92.49%). The findings addressed the study questions and were consistent with the study objectives, as the participants showed excellent overall knowledge (59.60-73.32%), with the significant gaps concerning the processes of the supply chain and regulatory mechanisms (44.00%). In Palestine, community pharmacy personnel reported that medicine shortages have adverse effects on patient adherence (83.68%), treatment continuity, and quality of life (86.79%), and add workload and ethical problems to the pharmacy staff. The frequent coping mechanisms were to contact more than one supplier, prescribers’ referral (55.18%), and alternative therapeutic options (25.62%). The qualitative results highlighted the necessity of better coordination with authorities, as well as the creation of a national early warning system. Conclusions: There is still an ongoing and multifaceted issue of medicine shortages within the community pharmacy practice in Palestine. The solution to this problem in Palestine must be context-sensitive national strategies to reinforce supply chain management and promote local production. To protect patient safety, it is vital to empower pharmacists by using an explicit protocol of substitution and interprofessional collaboration.