EXTEMPORANEOUS COMPOUNDING PRACTICE BY PHARMACISTS: A SYSTEMATIC REVIEW
Objective: To identify the frequency and scope of extemporaneous compounding practice reported in community and hospital pharmacies.
Methods: A systematic literature review was undertaken to identify the prevalence of extemporaneous compounding practice in community and hospital pharmacies, including the reasons of providing compounding services.
Results: Nine studies were identified and evaluated in which extemporaneous products prepared by pharmacist could be identified. Most of the studies record that prevalence of extemporaneous compounding practice is very low (less than 5%). Prescribing of compounded medicines occurs more frequently in paediatrics and for special patientsâ€™ need. The major types of extemporaneous compounding products were dermatological dosage forms and followed by oral solutions and oral suspensions. Reasons for providing compounding practice were to make a customised products that not available commercially and to provide full pharmaceutical care to patients. Issues about the stability of compounded products, accuracy in dose strength and lack of standardised protocol in extemporaneous compounding need to be addressed.
Conclusion: Extemporaneous compounding practice are an essential part of pharmacistâ€™ competency. These unique skills need to be preserved and regulations that cover rationalised compounding practice is necessary.
2. Yancey V, Yakimo R, Perry A, McPherson TB. Perceptions of pharmaceutical care among pharmacists offering compounding services. J Am Pharm Assoc 2008;48:508-14.
3. McPherson TB, Fontane PP. Patient-centered care in the community-based compounding practice setting. J Am Pharm Assoc 2010;50:37-44.
4. Uzondu AI, Okafor OJ. Prescription pattern of anxiolytic drugs used in orthopaedic patients: a case study of national orthopaedic Hospital, Enugu, Nigeria. Int J Pharm Chem Res 2013;5:133-40.
5. Richey RH, Craig JV, Shah UU, Ford JL, Barker CE, Peak M, et al. The manipulation of drugs to obtain the required dose: a systematic review. J Adv Nurs 2012;68:2103-12.
6. Nunn AJ, Richey RH, Shah UU, Barker CE, Craig JV, Peak M, et al. Estimating the requirement for manipulation of medicines to provide accurate doses for children. Eur J Hospital Pharm 2013;20:3-7.
7. Brion F, Nunn AJ, Rieutord A. Extemporaneous (magistral) preparation of oral medicines for children in European hospitals. Acta Paediatr 2003;92:486-90.
8. European Medicines Agency. About EMEA-structure 2007. Available from: www.emea.europa.eu/htms/aboutus/ emeaoverview.htm. [Last accessed on 10 Sep 2016]
9. Khan MU, Ahmad A. The impact of clinical pharmacistsâ€™ interventions on drug-related problems in a teaching based hospital. Int J Pharm Chem Res 2014;6:135-41.
10. Subramaniam V, Sokol G, Zenger V. Survey of drug products compounded by a group of community pharmacies: findings from a food and drug administration study; 2005. Available from: www.fda.gov/cder/pharmcomp/communityPharmacy/default.htm. [Last accessed on 05 Aug 2016].
11. Richey RH, Shah UU, Peak M, Craig JV, Ford JL, Nunn AJ, et al. Manipulation of drugs to achieve the required dose is intrinsic to paediatric practice but is not supported by guidelines or evidence. BMC Pediatrics 2013;13:1295-8.
12. Pappas A, MacPherson R, Stewart K. Extemporaneous prescribing: whatever happened to it? a survey of Australian general practitioners. J Pharm Pract Res 2002;32:310-4.
13. Zaid AN, Al-Ramahi R, Shahed Q, Saleh B, Elaraj J. Determinants and frequency of pharmaceutical compounding in pharmacy practice in Palestine. Indian J Physiol Pharmacol 2012;20:9-14.
14. McPherson TB, Fontane PE, Jackson KD, Martin KS, Berry T, Chereson R, et al. Prevalence of compounding in independent community pharmacy practice. J Am Pharm Assoc 2006;46:568-73.
15. Kairuz T, Myftiu J, Svirskis D, Hasan F, Lal A, Patel R, et al. Extemporaneous compounding in New Zealand hospitals. Indian J Physiol Pharmacol 2007;15:129-31.
16. Lindbald AK, Isacson D, Ericksson C. Assessment of the appropriateness of extemporaneous preparations prescribed in Swedish primary care. Int J Pharm Pract 1996;4:117-22.
17. Martin KS, Berry T, McPherson TB, Chereson R, Fontane PE, Bilger R. Independent community pharmacistsâ€™ perspectives on compounding in contemporary pharmacy education. Am J Pharm Educ 2009;73:70-6.
18. Buurma H, de Smet PAGM, van den Hoff OP, Sysling H, Storimans M, Egberts ACG. Frequency, nature and determinants of pharmacy compounded medicines in Dutch community pharmacies. Pharm World Sci 2003;25:280-7.
19. Verrue C, Mehuys E, Boussery K, Remon JP, Petrovic M. Tablet splitting: a common yet not so innocent practice. J Adv Nurs 2011;67:26-32.
20. Rennison SM, Portlock JC. Is it time to stop dispensing extemporaneously in community pharmacy? Int J Pharm Pract 2003;11:68-75.
21. Therapeutic Goods Administration. Meeting Report with Stakeholders on Extemporaneous Compounding. Canberra: Therapeutic Goods Administration; 2006.
22. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990;47:533-43.