How do medication shortages affect work routines of medical assistants? Results of a flash-mob study in Germany

Susanne Kersten, Achim Mortsiefer, Christine Kersting

Keywords: medical assistants; flash-mob study; medication supply shortages

Background:

The German health care system faces challenges due to supply shortages of prescription medication. These shortages have a negative impact on patient care and affect the work of medical assistants (MA), who are central for coordinating patient care.

Research questions:

Initiated by a MA, this study assessed the working situation of MA in times of medication shortages:
(1) Frequency of patient-requests associated with medication supply shortages.
(2) Workload caused by such requests.
(3) Stress level of MA related to these requests.

Method:

The study was developed using a participatory approach involving three MA. Finally, a cross-sectional flash-mob study was conducted in German general practices from November 27 to 30, 2023. Over four half days, participating MA documented each patient issue related to supply shortages, i.e., unavailable medication, whether a further physician consultation was necessary, duration of the patient contact and perceived stress. The recruitment strategy comprised personal practice visits, postal invitations of research practices, and invitations via newsletters and distribution lists of stakeholder groups. Analyses were performed using descriptive statistics.

Results:

Fifty-eight MA (all female, aged 19 to 63) from 23 general practices participated. Thirty-seven of them documented at total of 86 requests related to medication shortages. Most requests addressed antibiotics, eye ointment/drops, insulins, and narcotics and took less then five minutes (n=41, 47.7%). Half of the requests (n=42, 48.8%) could be solved by MA themselves; only 3.5% (n=3) remained unsolved. Even though MA felt insufficiently prepared for 56.1% of the requests (n=46), they only described 22.1% of the requests stressful (n=19).

Conclusions:

Despite the small database, the results indicate that supply shortages lead to additional work for MA. The fact that MA felt insufficiently prepared for the situation, but not excessively stressed might indicate that MA are able to cope with unpredictable situations as they represent their daily work.

Points for discussion:

Participatory research is feasible and creates a close and trusting connection to the target group:

1. Medical assistants demonstrated willingness to support the study as they even filled and sent the questionnaire on personal characteristics when no patient requests could be documented.

2. Several practices took time to provide written or personal feedback regarding the data collection period, pointing out that it did not represent the practices working reality as no or only few requests occurred in this time, while there were many requests the weeks before.

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