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Exploratory analysis for the implementation of antineoplastic logarithmic dose banding
A Albert-Marí1, S Valero-García2, V Fornés-Ferrer3
1Pharmacy Department, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain. albert_asu@gva.es.
International Journal of Clinical Pharmacy
|August 12, 2018
Summary
Dose banding (DB) can streamline antineoplastic production in hospital pharmacies. This strategy allows for 40% of doses to be prepared in advance, improving efficiency and capacity.
Area of Science:
- Pharmaceutical Sciences
- Oncology Pharmacy Practice
- Healthcare Operations
Background:
- Dose banding (DB) is a strategy to rationalize antineoplastic production in hospital pharmacy aseptic compounding units (ACUs).
- DB aims to optimize workflows, reduce patient waiting times, and enhance safety, quality, and efficiency.
- Implementation of DB can facilitate the adoption of new technologies in compounding.
Purpose of the Study:
- To evaluate the impact of implementing Logarithmic Dose Banding (DB).
- To identify antineoplastic agents and preparations suitable for DB based on established criteria.
- To determine the number of standard doses that could be compounded in advance at the ACU.
Main Methods:
- A retrospective observational study analyzed antineoplastic dose production from December 2015 to May 2016.
- Investigational drugs were excluded. Three criteria were applied: >250 preparations/year, psychochemical stability for ≥14 days, and ≤5 logarithmic doses covering ≥60% of individual doses.
- The main outcome measured was the number of antineoplastic agents, preparations, and logarithmic standard doses suitable for DB.
Main Results:
- Analysis included 15,436 individual antineoplastic doses for 69 agents.
- Nineteen antineoplastic drugs (27%), including 3 monoclonal antibodies and 16 cytotoxic agents, were identified as candidates for DB.
- A significant portion, 6285 (40%) of compounded doses, could be prepared in advance as 84 logarithmic standard doses.
Conclusions:
- Dose banding implementation can rationalize antineoplastic production in hospital pharmacies.
- This strategy has the potential to significantly increase the compounding capacity of ACUs.
- Logarithmic dose banding offers a viable approach to improve efficiency and patient care in antineoplastic compounding.
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