학술논문
Impact of the subcutaneous formulations of trastuzumab and rituximab on efficiency and resource optimization in Spanish hospitals: H-Excelencia study.
Document Type
Academic Journal
Author
Abad-Sazatornil MR; Hospital Pharmacy, Hospital Universitario Miguel Servet, P/ Isabel la Católica 1-3, 50009, Zaragoza, Spain. rabads@salud.aragon.es.; Arenaza A; Hospital Pharmacy, Hospital Clínico San Carlos, Madrid, Spain.; Bayo J; Oncology Unit, Hospital Juan Ramón Jiménez, Huelva, Spain.; García Mata J; Medical Oncology Unit, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.; Guinea De Castro JM; Haematology and Haemotherapy Unit, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, Spain.; León J; Hospital Pharmacy, Hospital Morales Meseguer, Murcia, Spain.; Letellez J; Hospital Pharmacy, Hospital de Fuenlabrada, Madrid, Spain.; Reguero V; Hospital De Cabueñes, Gijón, Asturias, Spain.; Martínez Chamorro C; Haematology Unit, Hospital Universitario Quirónsalud, Madrid, Spain.; Salar A; Haematology Unit, Hospital de Mar, Barcelona, Spain.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Subcutaneous (SC) versus intravenous (IV) administration is advantageous in terms of patient convenience and hospital efficiency. This study aimed to compare the effect of optimizing the processes involved in SC versus IV administration of rituximab and trastuzumab on hospital capacity and service quality.
Methods: This cross-sectional resource utilization study interviewed oncologists, hematologists, nurses, and pharmacists from 10 hospitals in Spain to estimate changes in processes associated with conversion from IV to SC rituximab and trastuzumab, based on clinical experience and healthcare use from administrative databases.
Results: Efficient use of SC formulations increased the monthly capacity for parenteral administration by 3.35% (potentially increasable by 5.75% with maximum possible conversion according to the product label). The weekly capacity for hospital pharmacy treatment preparation increased by 7.13% due to conversion to SC formulation and by 9.33% due to transferring SC preparation to the cancer treatment unit (potentially increasable by 12.16 and 14.10%, respectively). Monthly hospital time decreased by 33% with trastuzumab and 47% with rituximab. In a hypothetical hospital, in which all processes for efficient use of SC rituximab and/or trastuzumab were implemented and all eligible patients received SC formulations, the estimated monthly capacity for preparation and administration increased by 23.1% and estimated hospital times were reduced by 60-66%.
Conclusions: Conversion of trastuzumab and rituximab to SC administration could improve the efficiency of hospitals and optimize internal resource management processes, potentially increasing care capacity and improving the quality of care by reducing time spent by patients at hospitals.
Methods: This cross-sectional resource utilization study interviewed oncologists, hematologists, nurses, and pharmacists from 10 hospitals in Spain to estimate changes in processes associated with conversion from IV to SC rituximab and trastuzumab, based on clinical experience and healthcare use from administrative databases.
Results: Efficient use of SC formulations increased the monthly capacity for parenteral administration by 3.35% (potentially increasable by 5.75% with maximum possible conversion according to the product label). The weekly capacity for hospital pharmacy treatment preparation increased by 7.13% due to conversion to SC formulation and by 9.33% due to transferring SC preparation to the cancer treatment unit (potentially increasable by 12.16 and 14.10%, respectively). Monthly hospital time decreased by 33% with trastuzumab and 47% with rituximab. In a hypothetical hospital, in which all processes for efficient use of SC rituximab and/or trastuzumab were implemented and all eligible patients received SC formulations, the estimated monthly capacity for preparation and administration increased by 23.1% and estimated hospital times were reduced by 60-66%.
Conclusions: Conversion of trastuzumab and rituximab to SC administration could improve the efficiency of hospitals and optimize internal resource management processes, potentially increasing care capacity and improving the quality of care by reducing time spent by patients at hospitals.