Erin Fox - Academia.edu (original) (raw)
Papers by Erin Fox
Journal of Medical Toxicology, 2021
INTRODUCTION Both opioid and non-opioid analgesics are commonly utilized in treating acute and ch... more INTRODUCTION Both opioid and non-opioid analgesics are commonly utilized in treating acute and chronic pain in the emergency department (ED). Opioid stewardship efforts have focused on judicious opioid use and opioid alternatives as first-line analgesics. Parenteral opioid formulations have been impacted by periodic shortages creating the opportunity for a natural experiment to observe how emergency clinician prescribing behavior may be impacted. We investigated the change in analgesic practice related to a period of parenteral opioid shortage at two large urban, academic medical centers. METHODS A retrospective review of pharmacy administration data from two academic urban EDs was performed looking at time periods before, during, and after resolution of the parenteral opioid shortage. The data were analyzed by medication, dose, time, number of doses, and oral morphine milligram equivalents (MME) administered per patient. RESULTS The percentage of patients who received any opioid among ED visits decreased during the shortage period and did not return to pre-shortage levels after the shortage ended: 11.5% pre, 8.5% during (p=0.01), 7.2% post (NS; p=0.18). The number of doses of either oral or IV opioid doses administered during the shortage decreased significantly: 8.7% pre, 5.6% during (p=0.02) for PO, and 13.7% pre, 9.0% during (p=0.004) for IV, and neither changed during recovery from the shortage. The percentage of patients receiving non-opioid analgesics rose from 30.5% before to 45.8% (p=0.004) after the shortage. Among patients who received opioids, the MME per patient did not change across the time periods: 11.5% before, 11.2% during, 12.7% post. CONCLUSIONS A period of restricted opioid use due to parenteral opioid shortages led to less opioid use overall and fewer patients treated with opioids, yet no significant change in opioid MME administered per patient requiring opioids. Overall, the shift in opioid prescribing during the parenteral opioid shortage appeared to be sustained in the post-shortage period.
American Journal of Health-System Pharmacy, 2020
Clinical Pharmacology & Therapeutics, 2020
has a contract with Vizient to provide information about drug shortages. The amount represents le... more has a contract with Vizient to provide information about drug shortages. The amount represents less than 5% of the overall budget. Erin Fox has received the following support: for providing continuing education on drug shortages (partial travel support from: JCPP, AAMC,
Journal of Medical Toxicology, 2020
Journal of Medical Toxicology, 2020
American Journal of Health-System Pharmacy, 2020
Journal of Graduate Medical Education, 2020
American Journal of Health-System Pharmacy, 2019
The editor also again recognizes the leadership and vision of William A. Zellmer, the founding ed... more The editor also again recognizes the leadership and vision of William A. Zellmer, the founding editor of the ASHP Foundation Pharmacy Forecast series, for creating a resource for the profession that continues to have significant value.
American Journal of Health-System Pharmacy, 2019
Purpose The implementation and maintenance of a process for adding and removing hyperlinks to med... more Purpose The implementation and maintenance of a process for adding and removing hyperlinks to medication management policies and guidelines approved by a pharmacy and therapeutics (P&T) committee into the electronic health record (EHR) are described. Summary Medication management policies and guidelines approved by the P&T committee are published on the University of Utah Health intranet, making it possible to add hyperlinks to this information within the EHR. Adding these hyperlinks allows policy and guideline information to be available to clinicians on the medication ordering, verification, and administration screens without requiring a separate search of the intranet. In a quality-improvement project, all medication management policies and guidelines posted on the intranet were reviewed for relevance to the medication ordering, verification, and administration processes. Hyperlinks to relevant policies and guidelines were implemented into the EHR for specific medications. At the...
Pediatric Emergency Care, 2019
Objectives Drug shortages have been increasing over the past 2 decades. There are limited data on... more Objectives Drug shortages have been increasing over the past 2 decades. There are limited data on drug shortages and their effect on pediatric emergency and critical care. Our objective was to describe pediatric emergency and critical care drug shortages. Methods Drug shortage data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Services. Shortages were reviewed, identifying agents used in pediatric emergency and critical care. Shortage data were analyzed for the type of drug, formulation, shortage reason, duration, marketing status (generic vs brand name), or if it was a pediatric-friendly formulation, used for a high-acuity condition, or a single-source product. The availability of a substitute was also described. Results Of 1883 products on shortage, 779 were used in pediatric emergency or critical care. The annual number of shortages decreased from 2001 to 2004, but then increased, reaching a high in 2011. The median duration for resolved shortages was 7.6 months (interquartile range, 3.0–17.6 months). The most common category affected was infectious disease drugs. High-acuity agents were involved in 27% of shortages and in 11% of pediatric-friendly formulations. An alternative agent was available for 95% of drugs, yet 43% of alternatives were also affected at some time during the study period. The most common reported reason for a shortage was manufacturing problems. Conclusions From 2001 to 2015, drug shortages affected a substantial number of agents used in pediatric emergency and critical care. This has had implications to the medications available for use and may impact patient outcomes. Providers must be aware of current shortages and implement mitigation strategies to optimize patient care.
American Journal of Health-System Pharmacy, 2003
A health system's experience in monitoring drug s... more A health system's experience in monitoring drug shortages since 1996 within the organization and since 2001 on a national level is described. Since January 1996, the Drug Information Service (DIS) at the University of Utah Hospitals and Clinics (UUHSC) has systematically prepared written bulletins to affected practitioners when drug shortages occurred. The DIS began providing information on a national level to the American Society of Health-System Pharmacists in January 2001. A total of 224 drug shortages were tracked from January 1996 to June 2002. All shortages at UUHSC were also national shortages, but only about two thirds of national shortages also affected UUHSC. The most common reasons for shortages were manufacturing problems (28%) and product discontinuation (20%). The most frequently represented pharmacologic-therapeutic categories were central nervous system agents (24%) and serums, toxoids, and vaccines (17%). Of the 119 shortages in 2001, 70 (59%) were still ongoing as of the end of June 2002. The most common potential safety problems were that clinicians might be unfamiliar with the alternative agent (54%) and that the alternative's dosage requirement was different (50%). Over half of the shortages were cost neutral, but the assessment did not include substantial potential indirect costs. Detailed information on drug shortages collected by a health system's drug information service since 1996 indicated a trend toward more frequent shortages.
American Journal of Health-System Pharmacy, 2004
1. Am J Health Syst Pharm. 2004 Oct 1;61(19):2009. Measuring the impact of drug shortages. Fox ER... more 1. Am J Health Syst Pharm. 2004 Oct 1;61(19):2009. Measuring the impact of drug shortages. Fox ER, Tyler LS. Comment on: Am J Health Syst Pharm. 2004 Oct 1;61(19):2015-22. PMID: 15509121 [PubMed - indexed for MEDLINE]. Publication Types: Comment; Editorial. ...
American Journal of Health-System Pharmacy, 2019
Pediatrics, 2018
Medication shortages are increasingly common and severe in the United States and are a serious he... more Medication shortages are increasingly common and severe in the United States and are a serious health threat. Medication shortages occur when reduced supply of a drug influences how it is prepared, dispensed, or prescribed by pharmacies or providers. 1 According to the US Food and Drug Administration (FDA), most shortages are caused by quality and manufacturing problems. 2 Consequences of shortages include rationing limited supplies, delays in therapy, medication errors, use of lessefficacious alternatives, and death. 3 Recently, critical drugs like sodium chloride and amino acids have been on shortage, exacerbated by damage to manufacturing plants by natural disasters like Hurricane Maria. Although shortages have affected virtually all classes of medications, antimicrobial shortages are common and account for 15% of all drug shortages. 1, 4
The New England journal of medicine, Jan 19, 2018
The Journal of pediatrics, Jan 8, 2018
To describe contemporary drug shortages affecting general ambulatory pediatrics. Data from Januar... more To describe contemporary drug shortages affecting general ambulatory pediatrics. Data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Service. Two pediatricians reviewed drug shortages and identified agents used in ambulatory pediatrics. Shortage data were analyzed by the type of drug, formulation, reason for shortage, duration, marketing status, if a pediatric friendly-formulation was available, or if it was a single-source product. The availability of an alternative, and whether that alternative was affected by a shortage, also was noted. Of 1883 products in shortage during the study period, 314 were determined to be used in ambulatory pediatrics. The annual number of new pediatric shortages decreased initially but then increased to a high of 38 in 2011. Of the 314 pediatric shortages, 3.8% were unresolved at the end of the study. The median duration of resolved shortages was 7.6 months. The longest shortage was for ciprofloxacin 500-m...
Journal of critical care, Oct 9, 2017
We describe trends in U.S. shortages impacting critical care drugs from 2001 to 2016. Shortages w... more We describe trends in U.S. shortages impacting critical care drugs from 2001 to 2016. Shortages within the scope of critical care were identified using data from the University of Utah Drug Information Services. Shortage characteristics were described using standard descriptive statistics and regression analysis. Of 1969 shortages reported, 1004 (51%) were for drugs used in critical care. New shortages fell from 2001 to 2004, then increased, peaking in 2011 (116). For critical care shortages, 247 (24.6%) involved drugs used for high acuity conditions. The majority of drugs on shortage were parenteral, (720; 71.7%) and 393 (39.1%) were single source drugs. Alternatives were available for 887 (88.3%) drugs, although 250 (24.9%) alternatives were impacted by shortages. Infectious disease drugs were the most common drugs on shortage, with 200 (19.9%) shortages, with a median duration of 7.7months (IQR=2.8-17.3). By the end of the study, 896 (89.2%) shortages were resolved and 108 (10.8%...
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 22, 2016
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2016
Shortages and sudden price increases of certain drugs may both occur emergently, with little to n... more Shortages and sudden price increases of certain drugs may both occur emergently, with little to no warning, and they can have a dramatic impact on patient care. Little data are available linking drug shortages and price increases. Many of the same characteristics that may make medications susceptible to shortages can also place them at risk for sudden price increases. These characteristics include unapproved drugs, off-patent sole-source medications, and infrequently used medications. We reviewed drug shortage data from the University of Utah Drug Information Service to demonstrate how frequently these characteristics occurred and resulted in higher drug prices. Clinicians can use drug shortage management principles to mitigate the impact of sudden price increases for patients and health care organizations.
Gastroenterology, 2016
Learning Objective: Drug shortages have become more severe in recent years; however, there are li... more Learning Objective: Drug shortages have become more severe in recent years; however, there are limited data describing how shortages impact gastroenterology (GI) drugs. We characterize longitudinal trends in U.S. drug shortages within the scope of GI practice from 2001-14. Methods: Drug shortage data from the University of Utah Drug Information Service were analyzed from January 2001 to December 2014. A board certified gastroenterologist, an internal medicine physician and a clinical pharmacist identified drug shortages within the scope of GI practice, whether they are used for high-acuity conditions, availability, formulation and therapeutic category. Trends in the length of shortages for GI drugs were described using standard descriptive statistics and regression analysis. Results: 1,774 drug shortages were reported over the 14-year period. Of those, 253 shortages (14.3%) were classified as within the scope of GI practice. The number of newly-reported GI drug shortages increased from 15 in 2001 to 44 for the year 2014. Overall median shortage duration was 8.2 months (IQR 18.8). The drug with the largest number of repeated shortages was meropenem injection, with a total of 8 shortages over the study period. The longest single shortage duration was for ondansetron injection, with a total of 2262 shortage days. Of all GI drug shortages, 56 (22.1%) were for drugs used for high acuity conditions. The majority of GI drugs (55.7%) were parenteral and 102 shortages (40.3%) were single source drugs. Almost all (92.1%) of the GI drugs impacted by shortages had a therapeutic alternative, but over a third of these alternatives (34.0%) were also impacted by shortage at some point during the study period. Infectious disease drugs were the most common GI drugs on shortage, with 53 (20.9%) drug shortages totaling 838.1 months during the study period and a median duration of 10.3 months (IQR 20.0). By the end of the study period, 43 (17.0 %%) GI drugs remained on active shortage with a median duration of 24.1 months (IQR 25.0). The median duration for resolved shortages of GI drugs was 7.7 months (IQR 14.8). When provided, the most common reason for shortage was manufacturing problems (27%) followed by supply/demand (11%). Conclusions: There was a significant increase in shortages of drugs used in GI practice from 2001-14. Many of these drugs were used for highacuity conditions and alternative agents were also impacted. Gastroenterologists must be cognizant of current shortages in order to mitigate impact on patient care. Drug Shortages by Therapeutic Category Mo1096
Journal of Medical Toxicology, 2021
INTRODUCTION Both opioid and non-opioid analgesics are commonly utilized in treating acute and ch... more INTRODUCTION Both opioid and non-opioid analgesics are commonly utilized in treating acute and chronic pain in the emergency department (ED). Opioid stewardship efforts have focused on judicious opioid use and opioid alternatives as first-line analgesics. Parenteral opioid formulations have been impacted by periodic shortages creating the opportunity for a natural experiment to observe how emergency clinician prescribing behavior may be impacted. We investigated the change in analgesic practice related to a period of parenteral opioid shortage at two large urban, academic medical centers. METHODS A retrospective review of pharmacy administration data from two academic urban EDs was performed looking at time periods before, during, and after resolution of the parenteral opioid shortage. The data were analyzed by medication, dose, time, number of doses, and oral morphine milligram equivalents (MME) administered per patient. RESULTS The percentage of patients who received any opioid among ED visits decreased during the shortage period and did not return to pre-shortage levels after the shortage ended: 11.5% pre, 8.5% during (p=0.01), 7.2% post (NS; p=0.18). The number of doses of either oral or IV opioid doses administered during the shortage decreased significantly: 8.7% pre, 5.6% during (p=0.02) for PO, and 13.7% pre, 9.0% during (p=0.004) for IV, and neither changed during recovery from the shortage. The percentage of patients receiving non-opioid analgesics rose from 30.5% before to 45.8% (p=0.004) after the shortage. Among patients who received opioids, the MME per patient did not change across the time periods: 11.5% before, 11.2% during, 12.7% post. CONCLUSIONS A period of restricted opioid use due to parenteral opioid shortages led to less opioid use overall and fewer patients treated with opioids, yet no significant change in opioid MME administered per patient requiring opioids. Overall, the shift in opioid prescribing during the parenteral opioid shortage appeared to be sustained in the post-shortage period.
American Journal of Health-System Pharmacy, 2020
Clinical Pharmacology & Therapeutics, 2020
has a contract with Vizient to provide information about drug shortages. The amount represents le... more has a contract with Vizient to provide information about drug shortages. The amount represents less than 5% of the overall budget. Erin Fox has received the following support: for providing continuing education on drug shortages (partial travel support from: JCPP, AAMC,
Journal of Medical Toxicology, 2020
Journal of Medical Toxicology, 2020
American Journal of Health-System Pharmacy, 2020
Journal of Graduate Medical Education, 2020
American Journal of Health-System Pharmacy, 2019
The editor also again recognizes the leadership and vision of William A. Zellmer, the founding ed... more The editor also again recognizes the leadership and vision of William A. Zellmer, the founding editor of the ASHP Foundation Pharmacy Forecast series, for creating a resource for the profession that continues to have significant value.
American Journal of Health-System Pharmacy, 2019
Purpose The implementation and maintenance of a process for adding and removing hyperlinks to med... more Purpose The implementation and maintenance of a process for adding and removing hyperlinks to medication management policies and guidelines approved by a pharmacy and therapeutics (P&T) committee into the electronic health record (EHR) are described. Summary Medication management policies and guidelines approved by the P&T committee are published on the University of Utah Health intranet, making it possible to add hyperlinks to this information within the EHR. Adding these hyperlinks allows policy and guideline information to be available to clinicians on the medication ordering, verification, and administration screens without requiring a separate search of the intranet. In a quality-improvement project, all medication management policies and guidelines posted on the intranet were reviewed for relevance to the medication ordering, verification, and administration processes. Hyperlinks to relevant policies and guidelines were implemented into the EHR for specific medications. At the...
Pediatric Emergency Care, 2019
Objectives Drug shortages have been increasing over the past 2 decades. There are limited data on... more Objectives Drug shortages have been increasing over the past 2 decades. There are limited data on drug shortages and their effect on pediatric emergency and critical care. Our objective was to describe pediatric emergency and critical care drug shortages. Methods Drug shortage data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Services. Shortages were reviewed, identifying agents used in pediatric emergency and critical care. Shortage data were analyzed for the type of drug, formulation, shortage reason, duration, marketing status (generic vs brand name), or if it was a pediatric-friendly formulation, used for a high-acuity condition, or a single-source product. The availability of a substitute was also described. Results Of 1883 products on shortage, 779 were used in pediatric emergency or critical care. The annual number of shortages decreased from 2001 to 2004, but then increased, reaching a high in 2011. The median duration for resolved shortages was 7.6 months (interquartile range, 3.0–17.6 months). The most common category affected was infectious disease drugs. High-acuity agents were involved in 27% of shortages and in 11% of pediatric-friendly formulations. An alternative agent was available for 95% of drugs, yet 43% of alternatives were also affected at some time during the study period. The most common reported reason for a shortage was manufacturing problems. Conclusions From 2001 to 2015, drug shortages affected a substantial number of agents used in pediatric emergency and critical care. This has had implications to the medications available for use and may impact patient outcomes. Providers must be aware of current shortages and implement mitigation strategies to optimize patient care.
American Journal of Health-System Pharmacy, 2003
A health system's experience in monitoring drug s... more A health system's experience in monitoring drug shortages since 1996 within the organization and since 2001 on a national level is described. Since January 1996, the Drug Information Service (DIS) at the University of Utah Hospitals and Clinics (UUHSC) has systematically prepared written bulletins to affected practitioners when drug shortages occurred. The DIS began providing information on a national level to the American Society of Health-System Pharmacists in January 2001. A total of 224 drug shortages were tracked from January 1996 to June 2002. All shortages at UUHSC were also national shortages, but only about two thirds of national shortages also affected UUHSC. The most common reasons for shortages were manufacturing problems (28%) and product discontinuation (20%). The most frequently represented pharmacologic-therapeutic categories were central nervous system agents (24%) and serums, toxoids, and vaccines (17%). Of the 119 shortages in 2001, 70 (59%) were still ongoing as of the end of June 2002. The most common potential safety problems were that clinicians might be unfamiliar with the alternative agent (54%) and that the alternative's dosage requirement was different (50%). Over half of the shortages were cost neutral, but the assessment did not include substantial potential indirect costs. Detailed information on drug shortages collected by a health system's drug information service since 1996 indicated a trend toward more frequent shortages.
American Journal of Health-System Pharmacy, 2004
1. Am J Health Syst Pharm. 2004 Oct 1;61(19):2009. Measuring the impact of drug shortages. Fox ER... more 1. Am J Health Syst Pharm. 2004 Oct 1;61(19):2009. Measuring the impact of drug shortages. Fox ER, Tyler LS. Comment on: Am J Health Syst Pharm. 2004 Oct 1;61(19):2015-22. PMID: 15509121 [PubMed - indexed for MEDLINE]. Publication Types: Comment; Editorial. ...
American Journal of Health-System Pharmacy, 2019
Pediatrics, 2018
Medication shortages are increasingly common and severe in the United States and are a serious he... more Medication shortages are increasingly common and severe in the United States and are a serious health threat. Medication shortages occur when reduced supply of a drug influences how it is prepared, dispensed, or prescribed by pharmacies or providers. 1 According to the US Food and Drug Administration (FDA), most shortages are caused by quality and manufacturing problems. 2 Consequences of shortages include rationing limited supplies, delays in therapy, medication errors, use of lessefficacious alternatives, and death. 3 Recently, critical drugs like sodium chloride and amino acids have been on shortage, exacerbated by damage to manufacturing plants by natural disasters like Hurricane Maria. Although shortages have affected virtually all classes of medications, antimicrobial shortages are common and account for 15% of all drug shortages. 1, 4
The New England journal of medicine, Jan 19, 2018
The Journal of pediatrics, Jan 8, 2018
To describe contemporary drug shortages affecting general ambulatory pediatrics. Data from Januar... more To describe contemporary drug shortages affecting general ambulatory pediatrics. Data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Service. Two pediatricians reviewed drug shortages and identified agents used in ambulatory pediatrics. Shortage data were analyzed by the type of drug, formulation, reason for shortage, duration, marketing status, if a pediatric friendly-formulation was available, or if it was a single-source product. The availability of an alternative, and whether that alternative was affected by a shortage, also was noted. Of 1883 products in shortage during the study period, 314 were determined to be used in ambulatory pediatrics. The annual number of new pediatric shortages decreased initially but then increased to a high of 38 in 2011. Of the 314 pediatric shortages, 3.8% were unresolved at the end of the study. The median duration of resolved shortages was 7.6 months. The longest shortage was for ciprofloxacin 500-m...
Journal of critical care, Oct 9, 2017
We describe trends in U.S. shortages impacting critical care drugs from 2001 to 2016. Shortages w... more We describe trends in U.S. shortages impacting critical care drugs from 2001 to 2016. Shortages within the scope of critical care were identified using data from the University of Utah Drug Information Services. Shortage characteristics were described using standard descriptive statistics and regression analysis. Of 1969 shortages reported, 1004 (51%) were for drugs used in critical care. New shortages fell from 2001 to 2004, then increased, peaking in 2011 (116). For critical care shortages, 247 (24.6%) involved drugs used for high acuity conditions. The majority of drugs on shortage were parenteral, (720; 71.7%) and 393 (39.1%) were single source drugs. Alternatives were available for 887 (88.3%) drugs, although 250 (24.9%) alternatives were impacted by shortages. Infectious disease drugs were the most common drugs on shortage, with 200 (19.9%) shortages, with a median duration of 7.7months (IQR=2.8-17.3). By the end of the study, 896 (89.2%) shortages were resolved and 108 (10.8%...
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 22, 2016
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2016
Shortages and sudden price increases of certain drugs may both occur emergently, with little to n... more Shortages and sudden price increases of certain drugs may both occur emergently, with little to no warning, and they can have a dramatic impact on patient care. Little data are available linking drug shortages and price increases. Many of the same characteristics that may make medications susceptible to shortages can also place them at risk for sudden price increases. These characteristics include unapproved drugs, off-patent sole-source medications, and infrequently used medications. We reviewed drug shortage data from the University of Utah Drug Information Service to demonstrate how frequently these characteristics occurred and resulted in higher drug prices. Clinicians can use drug shortage management principles to mitigate the impact of sudden price increases for patients and health care organizations.
Gastroenterology, 2016
Learning Objective: Drug shortages have become more severe in recent years; however, there are li... more Learning Objective: Drug shortages have become more severe in recent years; however, there are limited data describing how shortages impact gastroenterology (GI) drugs. We characterize longitudinal trends in U.S. drug shortages within the scope of GI practice from 2001-14. Methods: Drug shortage data from the University of Utah Drug Information Service were analyzed from January 2001 to December 2014. A board certified gastroenterologist, an internal medicine physician and a clinical pharmacist identified drug shortages within the scope of GI practice, whether they are used for high-acuity conditions, availability, formulation and therapeutic category. Trends in the length of shortages for GI drugs were described using standard descriptive statistics and regression analysis. Results: 1,774 drug shortages were reported over the 14-year period. Of those, 253 shortages (14.3%) were classified as within the scope of GI practice. The number of newly-reported GI drug shortages increased from 15 in 2001 to 44 for the year 2014. Overall median shortage duration was 8.2 months (IQR 18.8). The drug with the largest number of repeated shortages was meropenem injection, with a total of 8 shortages over the study period. The longest single shortage duration was for ondansetron injection, with a total of 2262 shortage days. Of all GI drug shortages, 56 (22.1%) were for drugs used for high acuity conditions. The majority of GI drugs (55.7%) were parenteral and 102 shortages (40.3%) were single source drugs. Almost all (92.1%) of the GI drugs impacted by shortages had a therapeutic alternative, but over a third of these alternatives (34.0%) were also impacted by shortage at some point during the study period. Infectious disease drugs were the most common GI drugs on shortage, with 53 (20.9%) drug shortages totaling 838.1 months during the study period and a median duration of 10.3 months (IQR 20.0). By the end of the study period, 43 (17.0 %%) GI drugs remained on active shortage with a median duration of 24.1 months (IQR 25.0). The median duration for resolved shortages of GI drugs was 7.7 months (IQR 14.8). When provided, the most common reason for shortage was manufacturing problems (27%) followed by supply/demand (11%). Conclusions: There was a significant increase in shortages of drugs used in GI practice from 2001-14. Many of these drugs were used for highacuity conditions and alternative agents were also impacted. Gastroenterologists must be cognizant of current shortages in order to mitigate impact on patient care. Drug Shortages by Therapeutic Category Mo1096