Variability in Compounding of Oral Liquids for Children
Other limitations should be noted in the interpretation of survey results.
While more than 12% of Michigan pharmacies responded to the survey, the sample size has limited generalizability. Larger response rates may be achieved with a survey limited to a smaller number of medications to decrease time necessary for survey completion.
A more comprehensive survey of baseline practices was used, as responses were intended to inform further phases of an initiative to establish standard concentrations for statewide implementation. The sample was also underrepresented by chain pharmacies, as some chains had corporate policies restricting information sharing. Consequently, the true variability in compounding practices may be greater than survey results indicate. However, the majority of respondents practiced in an outpatient setting.
It should also be noted that not all Michigan pharmacies compound pediatric oral liquid medications. For this reason, such pharmacies may have elected not to respond to the survey.
A survey question designed to determine the title of person completing the survey (e.g., pharmacist or technician) was not included. It is possible that technicians may have responded in a different manner than pharmacists.
Another limitation of the survey is lack of questioning about whether specific formulations had been dispensed or how recently formulations had been dispensed. It is possible that some pharmacies may have had formulations but may not have recently or ever dispensed a prescription for the formulation.
The survey was titled Standardization of Oral Liquids for Pediatric Patients Survey and a question specifically asked, "Does your pharmacy ever compound oral liquids for pediatric use?" Nevertheless, respondents could have answered based on compounding liquids for purposes other than pediatric use. Future survey versions should use "compound oral liquids for pediatric use" throughout the survey to ensure clarity in response.
Finally, the iPad drawing used as an incentive for completion of the survey may have resulted in social desirability bias.
Limitations
Other limitations should be noted in the interpretation of survey results.
While more than 12% of Michigan pharmacies responded to the survey, the sample size has limited generalizability. Larger response rates may be achieved with a survey limited to a smaller number of medications to decrease time necessary for survey completion.
A more comprehensive survey of baseline practices was used, as responses were intended to inform further phases of an initiative to establish standard concentrations for statewide implementation. The sample was also underrepresented by chain pharmacies, as some chains had corporate policies restricting information sharing. Consequently, the true variability in compounding practices may be greater than survey results indicate. However, the majority of respondents practiced in an outpatient setting.
It should also be noted that not all Michigan pharmacies compound pediatric oral liquid medications. For this reason, such pharmacies may have elected not to respond to the survey.
A survey question designed to determine the title of person completing the survey (e.g., pharmacist or technician) was not included. It is possible that technicians may have responded in a different manner than pharmacists.
Another limitation of the survey is lack of questioning about whether specific formulations had been dispensed or how recently formulations had been dispensed. It is possible that some pharmacies may have had formulations but may not have recently or ever dispensed a prescription for the formulation.
The survey was titled Standardization of Oral Liquids for Pediatric Patients Survey and a question specifically asked, "Does your pharmacy ever compound oral liquids for pediatric use?" Nevertheless, respondents could have answered based on compounding liquids for purposes other than pediatric use. Future survey versions should use "compound oral liquids for pediatric use" throughout the survey to ensure clarity in response.
Finally, the iPad drawing used as an incentive for completion of the survey may have resulted in social desirability bias.