Department of Pharmacy, Rocky Mountain Cancer Centers, Greenwood Village, CO, USA.
Department of Medical Oncology Nursing, Rocky Mountain Cancer Centers, Greenwood Village, CO, USA.
Adv Ther. 2020 Jul;37(7):3265-3277. doi: 10.1007/s12325-020-01377-z. Epub 2020 May 23.
To evaluate the impact on cost, time, resource use, and clinic workflow of converting the route of drug administration from a neurokinin-1 receptor antagonist (NK-1 RA) 30-min intravenous (IV) infusion to aprepitant IV, and more specifically to IV push, within a multicenter community oncology practice.
This was a retrospective, multicenter time, motion, and resource/cost evaluation study. Conversion to aprepitant IV was determined by calculating number of doses of aprepitant IV versus fosaprepitant administered in patients receiving moderately or highly emetogenic chemotherapy regimens. Operational advantages (i.e., supply costs, time saved) of switching from fosaprepitant IV infusion to aprepitant administered as a 2-min IV push were assessed.
A total of 12,908 doses of aprepitant IV 130 mg were administered at 13 Rocky Mountain Cancer Centers clinics over an 18-month period. Conversion from fosaprepitant to aprepitant IV reached 90% after 9 months of aprepitant IV initiation. Supply costs per administration were reduced ($2.51 to $0.52) when aprepitant was prepared as an IV push versus an NK-1 RA infusion. The overall time savings per administration of aprepitant was reduced by 90% (from 36.5 to 3.5 min, 33 min saved) as an IV push rather than an infusion. Most of the time saved per administration (30 min) pertained to the infusion nurse, and 3 min was saved by the pharmacy technician.
Successful conversion to aprepitant, and specifically to a 2-min IV push, provides time, cost, and resource savings, improves operational efficiency, and avoids the negative impact of potential future IV fluid shortages.
评估将药物给药途径从神经激肽-1 受体拮抗剂（NK-1RA）30 分钟静脉输注转换为阿瑞匹坦静脉输注，更具体地说是静脉推注，对多中心社区肿瘤实践的成本、时间、资源利用和临床工作流程的影响。
这是一项回顾性、多中心的时间、动作和资源/成本评估研究。通过计算接受中度或高度致吐性化疗方案的患者中阿瑞匹坦静脉推注与福沙匹坦给药的剂量数来确定转换为阿瑞匹坦静脉输注。评估从福沙匹坦静脉输注转换为 2 分钟静脉推注阿瑞匹坦的操作优势（即供应成本、节省的时间）。
在 18 个月的时间里，13 家落基山癌症中心诊所共给予了 12908 剂 130mg 阿瑞匹坦静脉推注。在开始给予阿瑞匹坦静脉输注后的 9 个月内，福沙匹坦转换为阿瑞匹坦静脉输注达到 90%。当阿瑞匹坦作为静脉推注而不是 NK-1RA 输注时，每次给药的供应成本降低（从 2.51 美元降至 0.52 美元）。与输注相比，作为静脉推注给予阿瑞匹坦时，每次给药的总时间节省了 90%（从 36.5 分钟降至 3.5 分钟，节省 33 分钟）。每次给药节省的时间主要与输液护士有关（节省 30 分钟），药剂师节省 3 分钟。
成功转换为阿瑞匹坦，特别是转换为 2 分钟静脉推注，可节省时间、成本和资源，提高运营效率，并避免潜在未来静脉输液短缺的负面影响。
