Swan Joshua T, Zaghloul Hanna A, Cox James E, Murillo Jose R
College of Pharmacy and Health Sciences, Texas Southern University, Houston, Texas; Department of Pharmacy Services, Houston Methodist Hospital, Houston, Texas; Center for Outcomes Research, Department of Surgery, Houston Methodist Research Institute, Houston, Texas.
Pharmacotherapy. 2014 Jul;34(7):686-94. doi: 10.1002/phar.1420. Epub 2014 Apr 7.
To evaluate the impact of a pharmacy protocol that converts standard rituximab infusions to a rapid 90-minute infusion on the duration of outpatient infusion center clinic visits.
Prospective interventional study.
Outpatient infusion clinic at an academic medical center.
Sixty-four adults who received at least one rituximab infusion that was eligible for conversion to rapid infusion between August 2010 and July 2011 and who did not receive concurrent chemotherapy or colony-stimulating agents during the same clinic visit. Of the 64 patients, 37 received the rapid infusion (intervention cohort); 27 received the nonrapid infusion (control cohort).
Using a hospital-approved protocol, pharmacists converted rituximab infusions that met eligibility criteria (noninitial rituximab infusion, rituximab given in the previous 90 days, age 18 yrs or older, dose 375 mg/m(2) or less per infusion, dose 1000 mg or less per infusion, and no history of a grade 3 or higher reaction) to a rapid 90-minute infusion.
The durations of rituximab infusion time and clinic visit time were evaluated and compared between the intervention cohort and the control cohort. Use of the pharmacy protocol to convert standard rituximab infusion to rapid rituximab infusion reduced infusion time by 110.5 minutes/infusion (median 94.5 min [interquartile range (IQR) 90-105 min] for rapid infusion vs 205 min [IQR 138-263 min] for nonrapid infusion; p<0.001) and reduced clinic visit time by 92 minutes/outpatient encounter (median 233 min [IQR 208-277] min for rapid infusion vs 325 min [IQR 275-415 min] for nonrapid infusion; p<0.001). This resulted in a reduction of the duration of outpatient clinic visits by an estimated 255-299 hours in 1 year.
Use of a pharmacist protocol that converted standard rituximab infusions to a rapid 90-minute infusion decreased the duration of outpatient infusion clinic visits for rituximab infusion.
评估一项将标准利妥昔单抗输注转换为90分钟快速输注的药学方案对门诊输液中心就诊时间的影响。
前瞻性干预研究。
一所学术医疗中心的门诊输液诊所。
64名成年人，他们在2010年8月至2011年7月期间接受了至少一次符合转换为快速输注条件的利妥昔单抗输注，且在同一诊所就诊期间未接受同步化疗或集落刺激因子。64名患者中，37名接受快速输注（干预队列）；27名接受非快速输注（对照队列）。
药剂师使用医院批准的方案，将符合入选标准（非首次利妥昔单抗输注、前90天内使用过利妥昔单抗、年龄18岁及以上、每次输注剂量375mg/m²或更低、每次输注剂量1000mg或更低且无3级或更高反应史）的利妥昔单抗输注转换为90分钟快速输注。
评估并比较干预队列和对照队列中利妥昔单抗输注时间和就诊时间的长短。使用药学方案将标准利妥昔单抗输注转换为快速利妥昔单抗输注后，每次输注的时间缩短了110.5分钟（快速输注的中位数为94.5分钟[四分位间距（IQR）90 - 105分钟]，非快速输注为205分钟[IQR 138 - 263分钟]；p<0.001），每次门诊就诊时间缩短了92分钟（快速输注的中位数为233分钟[IQR 208 - 277分钟]，非快速输注为325分钟[IQR 275 - 415分钟]；p<0.001）。这使得门诊就诊时间在1年内估计减少了255 - 299小时。
使用将标准利妥昔单抗输注转换为90分钟快速输注的药剂师方案可缩短利妥昔单抗输注的门诊输液诊所就诊时间。
