In this study, 8.3% of the drug sample distribution units had expired, similar to the proportion reported by Hall and others (6.3%). The presence of expired medications reflects a lack of structure in the management of drug samples in institutions. Almost 50% of the clinics in this study did not manage drug samples in a structured way. For example, there was no designated individual to take care of samples according to an established procedure. More often than not, pharmaceutical representatives dropped off the samples themselves, and the nurses or physicians simply checked expiration dates before handing out the samples. Several other studies have highlighted the few resources that have been invested in this area, as well as the lack of effective drug sample management.
The design of this study did not allow verification of the proportion of drug samples used by staff members of the institution. Nevertheless, a number of elements, such as the presence of products intended only for adults (e.g. vitamins for geriatric patients), suggested that this proportion was significant. Previous studies have noted that the proportion of samples taken for personal use by staff or their associates or by pharmaceutical representatives themselves ranges from one- third to more than half. levitra professional
This study had certain limitations. The number of drug samples might have been underestimated, given that the research team had to obtain consent from health care staff to access the locations where samples were stored. Some staff members might have been warned about the inventory process the day before, and some people postponed the inventory by booking an appointment with the research assistant at a later date. The lack of longitudinal analysis limits the ability to extrapolate the results over time. It is clear that most stock was periodically replaced by pharmaceutical representatives, but this cross-sectional study did not allow estimation of the annual quantity of samples received, handed out, returned, or discarded. Similarly, it is possible that the actual proportion of expired stock was higher, as certain individuals let it be known that they had done some cleaning up of the storage areas before the “unannounced” visit.
This study reports the inventory of drug samples in a health care institution and compliance levels with existing policies and procedures. Drug samples were found only in outpatient clinics, where they represented 2.4 times the amount of drug floor stock. Most drug sample doses inventoried were not listed on the hospital’s formulary. These results indicate that the use of drug samples is underestimated in hospital settings. Further studies should be conducted to evaluate the importance of drug samples in patient care and the risks associated with their use.