Peggi Guenter, PhD, RN

by Peggi Guenter, PhD, RN, Senior Director of Clinical Practice, Advocacy, and Research, A.S.P.E.N.

The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of clinical nutrition and metabolism.

During the past year, many circumstances and incidents have threatened the safety of parenteral nutrition (PN) as an important therapy—particularly the ongoing shortage of key IV ingredients, or components. A.S.P.E.N. is on the forefront of this crucial issue and has partnered with the American Society for Health-system Pharmacists (ASHP), the Institute of Safe Medication Practices (ISMP), the Food and Drug Administration Drug Shortage Program, the Digestive Disease National Coalition, the Oley Foundation, and PN product manufacturers to provide the latest updates and education to the clinicians caring for patients on PN.

A.S.P.E.N. recently released the results of its parenteral nutrition (PN) product shortages survey, with more than 500 respondents reporting critical current shortages, as well as those of longer duration. The nationwide survey collected more than 400 clinician comments, which helped illustrate in very human terms the severe impact PN product shortages are having on patients.

While one of the key shortages clinicians are facing is multivitamins, the critical shortage issue extends into several other areas of clinical nutrition and metabolism. Safety concerns have risen exponentially as well, as clinicians are forced to use less desirable, unfamiliar alternatives; the absence or delay in treatment can result in poor patient outcomes; the use of alternative drugs create otherwise preventable adverse events; there is a lack of advanced warning when drugs are nearly in shortage; and precious clinical hours are lost to time-consuming activities required to manage the shortages.

One of A.S.P.E.N.’s top priorities in addressing this crisis has been working with the FDA and advocating before Congress to approve legislation that would support the management of and prevention of drug shortages. With bills in both the House and Senate, S.3187 and H.R.5651, drug shortage legislation will be part of the Prescription User Fee Act (PDUFA) reauthorization. A.S.P.E.N. staff members have been meeting with the ASHP and FDA leadership, as well as with Congressional staff, to discuss our concerns with the current situation and push for the resolution and timely passage of legislation.

The drug shortage crisis will not improve on its own, and through A.S.P.E.N.’s advocacy and diligent clinician education, our goal is to address this now, before delays and disruptions in patient care become even more widespread. Please join us!

Visit our online Drug Shortage Update resource, located at www.nutritioncare.org/Professional_Resources/Drug_Shortages_Update/.

Educate yourself about this critical issue through the site’s online links to our national survey, including raw, qualitative data by state; recommendations for PN product shortages; and backgrounders on existing conditions and pending public policy.

Report shortages and/or adverse events via our online reporting forms.

Advocate for your patients by contacting your legislator. You can read the letter we, along with other organizations, wrote to Congress, and you can write to your own legislator using an online support letter template. Sometimes, grassroots advocacy is the most effective of all, and it all starts with your letters.

For more information and updates on this topic, contact Peggi Guenter, PhD, RN, Senior Director of Clinical Practice, Advocacy, and Research, A.S.P.E.N. at peggig@aspen.nutr.org.