Patient Experiences with Compounded Topical Pain Creams.

Topical pain therapy offers several potential advantages as an alternative or adjunct to oral analgesic therapy, including decrease in concurrent oral drug use, lower abuse potential, lower side effects and toxicity, and localized effects. A variety of drugs and cream bases designed to promote transdermal delivery allow for unlimited customization of compounded topical pain creams (CTPC) for specific patients. The purpose of this study was to understand why patients begin CTPC therapy, their perceptions of CTPC therapy, and their level of satisfaction with CTPC therapy. A self-administered survey was distributed to patients receiving a compounded prescription. There were 107 responses from CTPC users. The typical CTPC user was a 67 year old woman with pain in the neck, back, or feet. The median duration of CTPC use was 4.5 months. Pain specialists, general practitioners, podiatrists, and orthopedists were the primary prescribers of CTPC. The prescriber was the first person to suggest CTPC for most patients. The majority of patients had insurance coverage for the CTPC and paid an average of $24.41 out of pocket per prescription. Most patients were highly satisfied with all aspects of CTPC and were more satisfied with CTPC than other medications they had used for the medical condition previously.

Patient experiences with compounded medications.

OBJECTIVES: There are few data directly from patients regarding their experiences with compounded prescriptions (CRx). The purpose of this study was to determine how patients initiated CRx use and how they perceived their CRx therapy. METHODS: A cross-sectional mailed national survey design was used. Participating pharmacies distributed questionnaires to their patients when dispensing CRx. The questionnaire contained items relating to patient demographics, previous use of CRx, how the patient came to use CRx, how the pharmacy was chosen, and satisfaction with the CRx. RESULTS: Four hundred ninety-four usable responses were received. Respondents were predominantly female (82.3%) with an average age of 60.5 years. Most respondents received their CRx by mail or delivery service (78.2%). The average duration of CRx use was 30 months. Patients with insurance paid an average of $50.04 for the CRx, whereas uninsured patients paid an average of $116.20. Hormone replacement therapy (HRT; 50.1%) and pain management (23.1%) were the most frequent indications for CRx therapy. CRx were primarily used to replace (68.1%) rather than supplement (31.9%) previous medications. The prescriber was the first person to suggest CRx therapy (78.9%), and the prescriber's recommendation was important in choosing the compounding pharmacy (89.6%) for most patients. More than 95% of patients were satisfied with all aspects of CRx therapy except cost. Patients judged CRx as equally good or better than previous medications they had used for their medical condition. CONCLUSION: Respondents used CRx for HRT, pain treatment, and a variety of medical conditions. CRx were used primarily to replace other medications because of treatment failure or intolerable adverse effects. Respondents were satisfied with all aspects of CRx therapy with the exception of out-of-pocket cost. The prescriber's recommendation was the single most important factor in a patient choosing to use CRx and in choosing a compounding pharmacy.

Should Torsion Balance Technique Continue to be Taught to Pharmacy Students?

Objective. To determine the types of balances used in compounding pharmacies: torsion or digital. Methods. A survey was mailed to the pharmacist-in-charge at 698 pharmacies, representing 47% of the pharmacies in Missouri as of July 2013. The pharmacies were randomly selected and stratified by region into eight regions to ensure a representative sample. Information was gathered regarding the type and use of balances and pharmacists' perspectives on the need to teach torsion balance technique to pharmacy students. Results. The response rate for the survey was 53.3%. Out of the total responses received, those pharmacies having a torsion balance, digital balance or both were 46.8%, 27.4% and 11.8%, respectively. About 68.3% of respondents compound prescriptions. The study showed that 52% of compounding pharmacies use torsion balances in their practice. Of those with a balance in their pharmacy, 65.6% favored continuation of torsion balance instruction. Conclusions. Digital balances have become increasingly popular and have replaced torsion balances in some pharmacies, especially those that compound a significant number of prescriptions. The results of this study indicate that torsion balances remain integral to compounding practice. Therefore, students should continue being taught torsion balance technique at the college.

Independent community pharmacists' perspectives on compounding in contemporary pharmacy education.

OBJECTIVES: To identify compounding practices of independent community pharmacy practitioners in order to make recommendations for the development of curricular objectives for doctor of pharmacy (PharmD) programs. METHODS: Independent community practitioners were asked about compounding regarding their motivations, common activities, educational exposures, and recommendations for PharmD education. RESULTS: Most respondents (69%) accepted compounding as a component of pharmaceutical care and compounded dermatological preparations for local effects, oral solutions, and suspensions at least once a week. Ninety-five percent were exposed to compounding in required pharmacy school courses and most (98%) who identified compounding as a professional service offered in their pharmacy sought additional postgraduate compounding education. Regardless of the extent of compounding emphasis in the practices surveyed, 84% stated that PharmD curricula should include compounding. CONCLUSIONS: Pharmacy schools should define compounding curricular objectives and develop compounding abilities in a required laboratory course to prepare graduates for pharmaceutical care practice.

Prevalence of compounding in independent community pharmacy practice.

OBJECTIVES: To determine the extent of prescription compounding in independent community pharmacies and identify factors that influence the decision of independent pharmacists whether to provide compounding services. DESIGN: Cross-sectional survey. SETTING: Illinois, Missouri, Kansas, and Iowa. PARTICIPANTS: 370 pharmacists in charge. INTERVENTION: Anonymous questionnaire mailed in January 2005. MAIN OUTCOME MEASURES: Percentage of pharmacies that provide compounding; percentage of dispensed prescriptions that require compounding; factors contributing to decisions whether to provide compounding service. RESULTS: Overall, 94% of respondent pharmacies provided compounding services at the time of this survey. Prescriptions that required compounding represented less than 1% of total prescriptions for the majority (58.3%) of respondents. The main reasons for the decision to provide compounding service were wanting to provide full pharmaceutical care to patients (73.8% of compounders) and responding to requests by prescribers (48.7%). Pharmacies that did not provide compounding service cited the main reason as not receiving prescriptions that required compounding (63.6% of noncompounders). CONCLUSION: Compounding remains a component of pharmacy practice in the independent community setting. Prescriptions that required compounding represented 2.3% of all prescriptions dispensed by compounding pharmacies.