Claus Barbara, Pourcq Kaat De, Clottens Nele, Kruse Vibeke, Gemmel Paul, Vandenbroucke Johan
Department of Pharmacy, Ghent University Hospital, Ghent, Belgium.
Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
Eur J Hosp Pharm. 2018 Nov;25(6):334-336. doi: 10.1136/ejhpharm-2016-001093. Epub 2017 Mar 4.
Dose banding (DB) (dose rounding with predetermined variation with prescription) enables in-advance preparation of high-turnover anticancer drugs with potential benefit for pharmacy compounding work flow.
To analyse the impact of potential situations on the efficiency of DB in the pharmacy (safe and maximum storage), calculate preparation lead times and the potential full-time equivalent (FTE) benefit.
Candidate intravenous anticancer drugs were selected for logarithmic DB according to prescribing frequency, infusion volume and stability (usage data 2015 of the tertiary Ghent University Hospital, Belgium). With a selected DB set already stored, a 2-week time study (April/November 2015) provided lead times (between prescription and transfer) for just-in-time and DB preparations. A 'maximal' storage (using all drugs with a relative incidence of ≥2% recurrent monthly prescription) and a 'safe' storage scenario (lowest monthly prescribing pattern) were used to calculate the potential future FTE change.
Mean lead times for DB storage and just-in-time preparation were 17.1 min (95% CI 13.5 to 21.0) and 26.5 min (23.3 to 29.8). For 21 164 yearly preparations with already 5292 in DB (25%), 11 157 and 6 862 could be batch-produced in advance in a maximum storage and safe storage scenario, respectively. The existing FTE in 2015 of 5.41 could then be reduced to 4.91 and 5.27.
Further development of DB could contribute to pharmacy compounding efficiency.
剂量分档（DB）（根据处方进行预定变化的剂量舍入）能够提前准备高周转抗癌药物，对药房配药工作流程具有潜在益处。
分析潜在情况对药房中剂量分档（DB）效率（安全和最大存储）的影响，计算准备前置时间和潜在的全职等效（FTE）效益。
根据比利时根特大学三级医院2015年的用药数据，按照处方频率、输注量和稳定性选择候选静脉用抗癌药物进行对数剂量分档。在已经存储了选定的剂量分档组的情况下，进行了为期2周的时间研究（2015年4月/11月），以提供即时准备和剂量分档准备的前置时间（从处方到调配）。使用“最大”存储（使用所有月复现处方相对发生率≥2%的药物）和“安全”存储方案（最低月处方模式）来计算未来潜在的全职等效（FTE）变化。
剂量分档存储和即时准备的平均前置时间分别为17.1分钟（95%置信区间13.5至21.0）和26.5分钟（23.3至29.8）。对于每年21164次准备，其中已有5292次采用剂量分档（25%），在最大存储和安全存储方案中，分别可以提前批量生产11157次和6862次。2015年现有的全职等效（FTE）为5.41，届时可分别降至4.91和5.27。
剂量分档（DB）的进一步发展有助于提高药房配药效率。
