Managing Drug Shortages in iQemo

Depending on the affected drug (i.e. supportive medication or SACT) and the duration of the supply issue (i.e. short-term or long-term), one of the following methods used alongside effective communication, may assist with managing the drug shortage within iQemo.

Drug Substitutes

Enabling the prescriber or pharmacist to select a quickly accessible and correct alternative to the standard drug in the regimen, drug substitution is a useful method of managing temporary drug supply issues for supportive medications without the need to edit the regimen template.

To create the drug substitute(s)follow the steps below:

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1.     Go to the ‘Drug Formulary’ from the iQemo Homepage

2.     Search for the name of the drug which will become the new alternative, select the ‘Edit' button and navigate to the 'Favourites' tab to create the         drug favourite(s) for that drug.

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3.     Return to the ‘Drug Formulary’ and search for the drug with the existing supply issue

4.     Select the ‘Substitutes’ tab and then the ‘Add Substitute’ button

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5.     In the window that appears, search for the name of the alternative drug thenselect the ‘Add' button for the drug favourite(s) created in step 2.

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The drug favourite(s) will now be listed as a possible drug substitute(s) for the drug with the supply issue andon all prescriptions, the ‘Substitute drug’ button will now display against the drug with the supply issue.

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If the ‘Substitute drug’ button is selected, the prescriber or pharmacist is presented with the appropriate drug favourite(s) readyto substitute into the prescription, which when added will apply for this and all future cycles.

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The drug substitution method will still rely on effective communication with all prescribers and pharmacists, that a drug supply issue exists. However, it provides a way of quickly directing the prescriber to the correct alternative, and hopefully reduces the stress and burden of prolonged queries related to the drug shortage and the available alternatives.

When the supply issue is resolved the actions above can easily be reversed by returning to the previously affected drug and removing the alternative drug favourites under the substitutions tab.

Available to Prescribe

It may be advantageous to disable the ability to add a supportive medication into a prescription altogether, especially if no alternatives are available.

To disable the ability to add a drug into the prescription, follow the steps below:

1.      Go to the ‘Drug Formulary’ from the iQemo Homepage

2.     Search for the name of the drug with a supply issue, and select the ‘Edit' button to reach the 'Details' tab.

3.     Scroll down the page to the ‘Organisation Level Settings’, remove the tick from the ‘Available to prescribe?’ field and select the ‘Update’ button.

A prescriber or pharmacist will no longer be able to add the supportive medication into the prescription, as it will not appear in the search results when looking for the drug to add in.

If the supply issue is resolved then the actions above can easily be reversed by re-ticking the ‘Available to prescribe?’ box and selecting ‘Update’

Reporting & Notification

Should the drug supply issue involving a supportive medication become permanent or impact a SACT drug, then it may be necessary to change the drug within the regimen template.

To help identify regimens that contain a specific drug, the ‘Regimens by Drug’ report can be run.

Once the change has been made within the regimen template, in the latest version of iQemo (v1.17.0), it is possible to mark the change as either ‘critical’ or ‘non-critical’ as part of a ‘Regimen Change Warning’.

This results in the prescriber being prompted to either consider re-prescribing the existing treatment to the new regimen template based on the description of the changes, or forces the prescriber to re-prescribe to the new regimen template. Ensuring that the change made to the regimen is considered or enforced for all active patients.

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