Management of returned anti-neoplastic treatments and their reuse in oncology patients

Abstract

Objective

Analyse the profile of parenteral preparation and treatment (anti-neoplastic and supplementary) that were dispensed and returned to the Pharmacy Department, the reasons why they were not administered, their reuse and the associated direct costs.

Method

Longitudinal study over 8 months (October 2004-May 2005) in a tertiary hospital with centre for preparing anti-neoplastic agents (including supplementary treatment) in its Pharmacy Department. The variables studied, downloaded from the Oncofarm® application, are as follows: a) patients and diagnostics; b) returned treatments, classified by reason returned, pharmaco-therapeutic scheme, cycle, and day; c) returned preparations (anti-neoplastic and supplementary) that were reused; and d) direct costs.

Data is presented with its absolute and relative frequencies and confidence intervals of 95% normalised at 1000 patients/day.

Results

Eighty-four treatments were returned by 66 patients for a total of 139 preparations corresponding to 3429 patients/day. This figure represents 24.5 (95% CI, 19.6-30.2) treatments that were prepared and not administered per 1000 patients/day, mainly due to clinical causes (n=47). Colon neoplasia and treatment with 5-fluorouracil and levofolinic acid presented the highest number of returns. The returned preparations made up 1.45% (95% CI, 1.2-1.7) of those produced. The percentage of reuse is 98%, which results in savings of €10 432.55 (90% of the cost of the treatments that are returned).

Conclusions

The application of quality, effectiveness, and safety criteria to anti-neoplastic treatments that are prepared and returned to the Pharmacy Department allows a more efficient preparation process.