Management of returned anti-neoplastic treatments and their reuse in oncology patients

Farm Hosp. 2009 Jul-Aug;33(4):217-23.
[Article in English, Spanish]

Abstract

Objective: Analyse the profile of parenteral preparation and treatment (anti-neoplastic and supplementary) that were dispensed and returned to the Pharmacy Department, the reasons why they were not administered, their reuse and the associated direct costs.

Method: Longitudinal study over eight months (October 2004-May 2005) in a tertiary hospital with centre for preparing anti-neoplastic agents (including supplementary treatment) in its Pharmacy Department. The variables studied, downloaded from the Oncofarm® application, are as follows: (a) patients and diagnostics; (b) returned treatments, classified by reason returned, pharmaco-therapeutic scheme, cycle and day; (c) returned preparations (anti-neoplastic and supplementary) that were reused; and (d) direct costs. Data is presented with its absolute and relative frequencies and confidence intervals of 95% normalised at 1000 patients/day.

Results: 84 treatments were returned by 66 patients for a total of 139 preparations corresponding to 3,429 patients/day. This figure represents 24.5 (CI 95%, 19.6 to 30.2) treatments that were prepared and not administered per 1,000 patients/day, mainly due to clinical causes (n = 47). Colon neoplasia and treatment with 5-fluorouracil and levofolinic acid presented the highest number of returns. The returned preparations made up 1.45 % (CI 95%, 1.2 to 1.7) of those produced. The percentage of reuse is 98%, which results in savings of euro 10,432.55 (90% of the cost of the treatments that are returned).

Conclusions: The application of quality, effectiveness and safety criteria to anti-neoplastic treatments that are prepared and returned to the Pharmacy Department allows a more efficient preparation process.

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Drug Utilization / standards*
  • Humans
  • Longitudinal Studies
  • Neoplasms / drug therapy*

Substances

  • Antineoplastic Agents