GEDEFO-SEFH management of antineoplastic extravasations survey results.

INTRODUCTION: Extravasation is a potentially severe complication of intravenous administration of antineoplastic drugs. The limited data makes it difficult to develop an optimal management scheme. The objective of this study is to describe the clinical practice in the extravasation management of antineoplastic agents in Spanish centers. METHODS: An online survey was distributed to oncology pharmacists using the email distribution list of the Spanish Society of Hospital Pharmacists. Respondents were surveyed on the standard operational protocol (SOP) of extravasation, tissue damage risk classification, and specific measures of extravasation management. RESULTS: A total of 68 surveys were completed. A specific extravasation SOP was available in 82.4% centers. The pharmacist participates in the authorship (100%) and actively collaborates in extravasation management (76.5%). A tissue damage risk classification based on the three categories was mostly adopted (48.2%) and 73.2% applied specific criteria based on concentration and/or extravasated volume. Extravasation management was mainly performed with the application of physical measures and/or antidotes (91.2%). High variability in the choices of pharmacological and/or physical measures recommended is outstanding. CONCLUSION: The results of this study highlight the involvement of Spanish pharmacists in extravasation management, the application of physical measures and/or pharmacological measures as the method of choice in extravasation management, as well as the existing discrepancies in tissue damage risk classification and management recommendations.

Clasificación del daño tisular de antineoplásicos: Consenso del Grupo Español de Farmacia Oncológica / Classification of antineoplastic drug-induced tissue damage: a Consensus of the Spanish Oncology Pharmacy Group

Objetivo: Realizar un consenso de expertos utilizando el método Delphipara la clasificación del potencial de daño tisular de los antineoplásicosque facilite la toma de decisiones ante una extravasación.Método: El panel de evaluadores estaba formado por siete farmacéuticos del grupo de trabajo de extravasaciones. Otro actuó comocoordinador. Se revisó la probabilidad de daño tisular a partir de ochodocumentos de referencia. Se clasificaron en cuatro categorías: vesicante, irritante de alto riesgo, irritante de bajo riesgo y no irritante. Serealizaron dos rondas; tras éstas los fármacos con consenso < 70% sediscutieron en grupo de forma no anónima. Se analizó para cada ronda:la mediana del grado de consenso y ámbito intercuartílico (AIQ25-75),el grado de concordancia por categoría de daño tisular y el porcentaje de antineoplásicos con grado de consenso > 85% y del 100%.Se analizaron de forma separada los fármacos con discordancias declasificación entre los documentos consultados. Se utilizó el programaestadístico SPSS v23.0. (AU)

Objective: To reach at an expert consensus, using the Delphi method, forclassifying the tissue-damaging potential of antineoplastic drugs, in order tofacilitate the decision-making process in the event of extravasations.Method: The panel of expert evaluators was made up of seven pharmacists belonging to the working group on extravasations. Other memberserved as coordinator. The likelihood of tissue damage was reviewed on thebasis of eight reference documents. Four categories of drugs were established: vesicant (V); high risk irritant (HRI); low risk irritant (LRI) and non-irritant(NI). Two rounds of surveys were performed. The drugs with an agreementof less than 70% after the two rounds were discussed non-anonymously by thegroup. For each of the rounds the following was analysed: median ofthe degree of consensus and the interquartile range (IQR25-75), degreeof agreement by tissue damage category, and percentage of antineoplastics reaching a degree of consensus of over 85% and of 100%. Drugswhose classification differed in the various reference documents were assessed separately. SPSS v23.0 statistical software was used. (AU)