2025 Southeastern Residency Conference

Title: Compounded Medications: Understanding Who Drives the Conversation in Clinical Practice 
 
Author: Katherine Moutis 
 
Practice Site: Innovation Compounding  
 
BACKGROUND: According to Alliance for Pharmacy Compounding, approximately 1-3% of all prescriptions written in the United States are compounded medications. Compounded medications are individualized preparations for patients not achieving therapeutic goals with commercially available FDA-approved medications. The process for obtaining a prescription for a compounded preparation starts in the provider’s office. If a compounded medication is deemed appropriate, the healthcare provider will write a prescription specifying the active ingredients, dose, route of administration, dosage form, and dosing interval. A licensed pharmacist then prepares the medication to these specifications. Through the use of shared decision making, the provider or the patient may initiate the conversation for considering the use of a compounded medication. There is currently no data published on who initiates this conversation. The purpose of this study was to identify if patients or providers are more likely to initiate the conversation for considering the use of a compounded medication and determine if there is a difference in perceptions of who initiates this conversation. 
 
METHODS: Surveys were emailed to providers who had prescribed compounded medications and patients who had obtained compounded medications through one of the  16 pharmacies within the Revelation Pharma network since August of 2023.  The surveys were emailed to 7,907 providers and 55,000 patients via email on October 1, 2024. The survey closed on December 1, 2024. A total of 857 (792 patients and 65 providers) responses were collected. The survey questions concerning who initiates the conversation about compounded medications were open ended. To analyze the data, all responses were examined and categorized as patient, provider, or both. Responses that did not fit into any of these categories were excluded. Responses to the survey were compared and tested using a chi-square test. P values < 0.05 were considered statistically significant. 
 
Results: For both the patient and provider surveys, 75% of responses indicated that the provider initiates the conversation about compounded medications (P = 0.951). One percent of providers and 18% of patients reported that the patient initiated the conversation about compounded medications (P = 0.003). Twenty-four percent of providers and 7% of patients reported that both the patient and the provider initiated the conversation about compounded medications (P < 0.001).  
 
Conclusions: The majority of both patients and providers reported that the providers are most commonly introducing compounded medications as a therapeutic option. This may be important when identifying audiences for education about the appropriate use of compounded medications and the availability of new compounded medications.