Extemporaneous compounding in Australian community pharmacies: extent, nature, and opinions

OBJECTIVES: This study explores the extent and nature of compounding practices, and the relevant experiences and opinions of pharmacists within Australian community pharmacies. METHODS: A cross-sectional observational study was conducted using a self-administered survey that was emailed to 3349 Australian community pharmacies. The survey collected information on the extent and nature of compounding, as well as the experiences and opinions of pharmacists, using Likert scales and free-text responses. Comparisons were made between pharmacies that identified as compounding pharmacies ('specialized pharmacies') and those that did not ('non-specialized pharmacies'). KEY FINDINGS: Of the 270 responses analyzed, 95.9% (n = 259) of pharmacies undertook on-site compounding and 4.1% (n = 11) did not. Moreover, 9.6% (n = 26) of pharmacies identified themselves as specialized compounding pharmacies. Specialized pharmacies prepared greater volumes of compounded prescriptions and were more likely to undertake complex compounding compared to non-specialized pharmacies. A minority of non-specialized pharmacies (10.7%; n = 25) reported compounding complex products, which are considered outside of their scope of practice according to the national guidelines. Approximately one-third of all pharmacist respondents (31.5%; n = 63) were unaware of the guideline changes in 2015. The use of Standard Operating Procedures for compounding was reported by just over half of the pharmacists (58.8%; n = 124). CONCLUSIONS: Compounding is common among Australian community pharmacies. While specialized pharmacies primarily perform complex compounding, some non-specialized pharmacies also compound complex products, indicating a potential lack of awareness of the 2015 guideline and a need for educational support. Future research is needed to ascertain practice changes following guideline revisions in 2024.