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Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice

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Published on: October 27, 2014

Reducing harm from paclitaxel infusion using titration rate: A quality improvement project.

¹Scarborough Health Network, hsheikh1@hotmail.com.

Canadian Oncology Nursing Journal = Revue Canadienne De Nursing Oncologique

|August 28, 2025

Summary

A new titration strategy significantly reduced paclitaxel infusion reactions and overall chair time in cancer patients. This quality improvement initiative improved patient care and clinic efficiency.

Keywords:

Paclitaxel cancer chemotherapy hypersensitive reactions (HSRs)infusion reaction titration rate

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Area of Science:

Oncology
Pharmacology
Quality Improvement

Background:

Paclitaxel infusion reactions were the most frequent Cancer Medication Infusion Reactions (CMIR) at Scarborough Health Network (SHN).
Despite pre-medication, paclitaxel reactions posed a challenge, leading to extended patient chair time.
A quality improvement project was initiated to address these paclitaxel infusion reactions.

Purpose of the Study:

To reduce the incidence of paclitaxel infusion reactions.
To decrease the extended chair time associated with these reactions.
To optimize patient flow and treatment delivery in the oncology clinic.

Main Methods:

Implemented a standardized titration rate strategy for the first three paclitaxel infusions in patients with solid tumors or hematologic malignancies.
Monitored paclitaxel reaction rates using the new titration strategy.
Compared reaction rates and chair time over two 4-month periods: one with titration rates and one without.

Main Results:

Paclitaxel reactions decreased to 35.71% with the titration strategy, compared to 51.35% without it.
While scheduled chair time increased by 30 minutes for slower infusions, this was less disruptive than unplanned 3-hour extensions for hypersensitivity reactions (HSRs).

Conclusions:

The standardized titration rate strategy effectively reduced hypersensitivity reactions (HSRs) in patients receiving paclitaxel.
This strategy also contributed to a reduction in overall clinic chair time, improving operational efficiency.