Zuziak Sandra, Topór-Madry Roman, Pilc Andrzej, Bochenek Tomasz
Pol Merkur Lekarski. 2014 Jul;37(217):43-8.
Until recently, the cytostatic drugs were being prepared at the Polish hospitals by the nursing staff on hospital wards, however according to the Pharmaceutical Law, preparation of cytostatic drugs, as a pharmaceutical service, should be performed by the pharmacists, who possess appropriate qualifications and experience in working within aseptic conditions and who are trained in professional handling with harmful substances. The aim of this paper has been to assess the impact, which establishment of the cytostatic drugs unit at the hospital pharmacy of the big oncologic hospital, located in southern Poland, had on the overall costs of cytostatic drugs utilization.
The analysis of drugs consumption, as well as determining the size of losses of particular active substances, prepared by the cytostatic drugs unit, have been based on statistical reports, provided by the hospital pharmacy. In order to calculate the level of consumption and losses of active substances in the chemotherapy ward, in framework of the previous modality of function, the estimations have been done, taking into consideration the same needs of particular patients, as those included within reports provided by the pharmacy. The actual prices of drugs from year 2012 have been applied in the assessment of costs of drug utilization. The calculations have been done with Excel and SPSS v.21 software. The methods of descriptive statistics and the comparison of groups, using the Student's t-test for dependent samples have been applied.
Due to functioning of the centralized modality of cytostatic drugs preparation within the specialized unit, the decline of overall cytostatic drug consumption, amounting to 9.73% has been observed. The reduction in losses, on stage of preparation of drugs, has been achieved and the share of these losses within overall consumption of drugs has dropped by 77.28%. The dissolution of cytostatic drugs in the cytostatic drugs unit, instead of the chemotherapy ward, allows the hospital to achieve the yearly savings, exceeding PLN 572,276.07.
Establisment of the cytostatic drugs unit, at the hospital pharmacy of the specialist oncologic hospital, not only allowed for increasing quality of pharmacotherapy, but also for substantial savings, when compared with the previously used method of dissolving and preparing cytostatic drugs by the nurses, instantly at the chemotherapy wards.
直到最近，波兰医院的细胞毒性药物一直由病房的护理人员配制，但根据《药品法》，细胞毒性药物的配制作为一项药学服务，应由具备在无菌条件下工作的适当资质和经验且接受过有害物质专业处理培训的药剂师进行。本文的目的是评估位于波兰南部的大型肿瘤医院药房设立细胞毒性药物配制单元对细胞毒性药物总体使用成本的影响。
对药物消耗的分析以及确定细胞毒性药物配制单元配制的特定活性物质的损失量，基于医院药房提供的统计报告。为了计算化疗病房中活性物质的消耗水平和损失量，在先前的功能模式框架下，考虑到与药房提供的报告中相同的特定患者需求进行了估算。2012年药物的实际价格用于评估药物使用成本。计算使用Excel和SPSS v.21软件完成。应用了描述性统计方法以及使用配对样本t检验的组间比较方法。
由于在专门单元内采用细胞毒性药物集中配制模式，观察到细胞毒性药物总体消耗量下降了9.73%。在药物配制阶段实现了损失的减少，这些损失在药物总消耗量中的占比下降了77.28%。在细胞毒性药物配制单元而非化疗病房溶解细胞毒性药物，使医院每年节省超过572,276.07波兰兹罗提。
在专科肿瘤医院药房设立细胞毒性药物配制单元，与之前护士在化疗病房即时溶解和配制细胞毒性药物的方法相比，不仅提高了药物治疗质量，还实现了大幅节约。
