Background and importance The administration of intravenous admixtures (IVMs) in the haemato-oncology day hospital is determined by the patient‘s health status. Poor health is a cause of non-administration of IVMs, causing medication and economic losses due to their low stability.
Aim and objectives To implement a protocol for the preparation of IVMs of antineoplastic drugs with high economic impact, low physical–chemical stability and/or high frequency of adverse effects; and to analyse the results obtained and to propose lines of improvement.
Material and methods The protocol consisted of review of the analytical data available early in the morning by the pharmacist and assessment of the physical condition of the patient by the nursing staff before preparation. All data on IVMs of the drugs included in this protocol and their cost were collected as well as the total number of IVMs prepared over a period of 3 months. We calculated the percentage of unprepared IVMs overall and per drug, including the amount of IVMs unprepared and the savings that they represented with respect to the total number of controlled IVMs.
Results The number of drugs included in the protocol was 17. In the period evaluated, a total of 5426 IVMs of antineoplastics were programmed: 399 IVMs were included in the protocol. Of these, 58 (14.5%) IVMs were not prepared. Seven of the 17 drugs included in the protocol presented causes for not being administered and, therefore, were not prepared. Drugs not prepared: panitumumab and nab-paclitaxel (10.4%), eribulin (8.6%), nivolumab and aflibercept (5.2%), pemetrexed and liposomal doxorubicin (1.7%). Fluorouracil (13.7%), gemcitabine (6.9%), oxaliplatin and irinotecan (5.2%), carboplatin and denosumab (3.4%) were not prepared in association with these drugs. The most frequent reasons for non-preparation were haematological adverse effects (36 (62.0%)), digestive adverse effects (10 (17.2%)), surgical intervention (4 (6.8%)) and other (4 (6.8%)). The economic savings in unprepared mixtures was €24 703.24 (7.1% of the total controlled mixtures included).
Conclusion and relevance The protocol was an important tool for cost savings in the preparation of antineoplastic IVMs. Of the drugs involved, only a limited number had reasons not to be prepared, so that the protocol could be updated with a smaller number of drugs while maintaining its objectives.
References and/or acknowledgements No conflict of interest.
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