[Dose intensity received in breast cancer treatment with chemotherapy]. / Intensidad de dosis recibida en el tratamiento quimioterápico del cáncer de mama.

OBJECTIVE: To know relative dose intensity (RDI) in patients with breast cancer treated with chemotherapy. To determine the number of patients where RDI was < 85% of that programmed and the possible cause. METHOD: Retrospective study, four-month selection period. The following were recorded: age, body surface, protocol applied, intention of treatment, frequency of administration of cycles, number of cytostatic treatments previously received and filgrastim administration. The average RDI per patient and protocol was calculated. RESULTS: 110 patients were analysed, the average age of them being 55.4 years (interval: 31-84), average body surface 1.7 m2 (1.3-2.4). Overall average RDI was 91.0% (SD 10.7). 93.8% (10.6), 95.8% (6.3) and 81.9% (18.5) in neoadjuvant, adjuvant and palliative treatments, respectively. 20% of the patients did not reach a RDI = 85% of that programmed, average RDI 69.5% (3.29). A delay in the administration of chemotherapy equal or greater than seven days occurred in 45.4% of the cases, average RDI 80.7% (16.0). In the episodes where the dose was reduced because of toxicity, the RDI was 75.6% (13.6). Significant inverse ratios were obtained with age (p = 0.02) and line of treatment (p = 0.03) with the RDI. In 36.8%, dose reduction was caused by neutropenia; 52.9% received filgrastim. CONCLUSIONS: Most patients received the appropriate RDI. Age, previous treatments and intention of treatment were the variables with the greatest impact on the dose received. The delay in administering the cycle was the most frequent act minimising the toxicity and which least affected the treatment.

Intensidad de dosis recibida en el tratamiento quimioterápico del cáncer de mama / No disponible

Objetivo: Conocer las intensidades de dosis relativas (IDR) enpacientes con cáncer de mama y tratamiento quimioterápico.Determinar el número de pacientes donde la IDR fue < 85% de laprogramada y posible causa.Método: Estudio retrospectivo, periodo de selección de 4 meses.Se registraron: edad, superficie corporal, protocolo administrado,intención de tratamiento, frecuencia de administración de ciclos,número de tratamientos citostáticos recibidos anteriormente y administraciónde filgrastim. Se calculó la IDR media por paciente y protocolo.Resultados: Se analizaron 110 pacientes, edad media 55,4años (intervalo: 31-84), superficie corporal media 1,7 m2 (1,3-2,4). La IDR media global fue 91,0% (DE 10,7). Del 93,8%(10,6), 95,8% (6,3) y 81,9% (18,5) en neoadyuvancia, adyuvanciay tratamiento paliativo, respectivamente. El 20% de pacientesno alcanzó una IDR >= 85% de la programada, IDR media 69,5%(3,29). Un retraso en la administración de quimioterapia igual osuperior a 7 días ocurrió en un 45,4% de los casos, IDR media80,7% (16,0). En los episodios donde se disminuyó la dosis portoxicidad la IDR media fue 75,6% (13,6). Se obtuvieron relacionesinversas significativas de la edad (p = 0,02) y línea de tratamiento(p = 0,03) con la IDR. En un 36,8% la reducción de dosisfue por neutropenia, recibiendo filgrastim el 52,9%.Conclusiones: La mayoría de pacientes recibió una IDR adecuada.La edad, tratamientos anteriores e intención de tratamientofueron las variables que más afectaron a la dosis recibida. Elretraso en la administración del ciclo fue la actuación más frecuentepara minimizar la toxicidad y que menos afectó al tratamiento

Objective: To know relative dose intensity (RDI) in patientswith breast cancer treated with chemotherapy. To determine thenumber of patients where RDI was < 85% of that programmedand the possible cause.Method: Retrospective study, four-month selection period.The following were recorded: age, body surface, protocol applied,intention of treatment, frequency of administration of cycles,number of cytostatic treatments previously received and filgrastimadministration. The average RDI per patient and protocol was calculated.Results: 110 patients were analysed, the average age of thembeing 55.4 years (interval: 31-84), average body surface 1.7 m2(1.3-2.4). Overall average RDI was 91.0% (SD 10.7). 93.8%(10.6), 95.8% (6.3) and 81.9% (18.5) in neoadjuvant, adjuvantand palliative treatments, respectively. 20% of the patients did notreach a RDI >= 85% of that programmed, average RDI 69.5%(3.29). A delay in the administration of chemotherapy equal orgreater than seven days occurred in 45.4% of the cases, averageRDI 80.7% (16.0). In the episodes where the dose was reducedbecause of toxicity, the RDI was 75.6% (13.6). Significant inverseratios were obtained with age (p = 0.02) and line of treatment(p = 0.03) with the RDI. In 36.8%, dose reduction was caused byneutropenia; 52.9% received filgrastim.Conclusions: Most patients received the appropriate RDI.Age, previous treatments and intention of treatment were thevariables with the greatest impact on the dose received. The delayin administering the cycle was the most frequent act minimisingthe toxicity and which least affected the treatment

[Financial assessment of device for the preparation of intravenous mixtures in hospital pharmacy]. / Evaluación económica de un dispositivo para preparación de mezclas intravenosas en farmacia hospitalaria.

OBJECTIVE: To financially assess a device for the preparation of intravenous mixtures (DPIVM) --Grifill system-- such as IV gammaglobulin, salbutamol, ondansetron/dexametasone, cisplatin rehydrating solution and mesna. MATERIAL AND METHODS: The most relevant resources used in the preparation and rebottling of each of the above-mentioned intravenous mixtures (for both the DPIVM and the commonly used alternative system) are assessed, as well as unitary costs (obtained from six Spanish hospitals enrolled), and an approach to the real cost by system used is obtained. A sensitivity analysis is performed considering most influencing variables. Results are calculated for one month of system operation. RESULTS: For IV gammaglobulin, mesna, salbutamol, ondansetron/dexametasone and polyionic solutions DPIVM resulted in financial benefit, but it did not in the preparation of cisplatin rehydrating solution. CONCLUSIONS: An individualized study in each center is needed to achieve reliable financial data on the system's profitability at hospital pharmacy departments. DPIVM may allow significant financial savings in centers and hospital departments using high-cost pharmaceuticals susceptible of customized dosing --e. g., IV gammaglobulin, other blood derivatives, monoclonal antibodies and/or antibiotics-- or intravenous mixtures requiring pharmaceuticals usually purchased directly from the manufacturer that may be prepared from low-cost raw materials (for instance, salbutamol and polyionic solution) requiring high-quality manipulation (e. g., sterility and precision).

[Impact of an intravenous mixture preparation device in hospital Pharmacy Departments. Perceived healthcare quality and user satisfaction]. / Impacto de un dispositivo de preparación de mezclas intravenosas en farmacia hospitalaria. Percepción de calidad asistencial y satisfacción del usuario.

OBJECTIVE: To integrally assess an intravenous mixture preparation device (IMPD) from the point of view of perceived healthcare improvement in a center (operational and organizational changes of the hospitals pharmacy department, staff nurse satisfaction and end-user satisfaction). MATERIAL AND METHODS: An observational, multicenter and domestic healthcare technology assessment project (an analysis to estimate relative value and contribution of a specific healthcare technology to both individual and collective health) is under discussion. Data were obtained from 6 Spanish hospitals. RESULTS: In 3 out of 4 Pharmacy Departments surveyed, reports on the use of IMPD showed that this system contributed to time saving, as well as improved preparation quality and system safety. From a nursing standpoint, the use of IMPD was mostly considered satisfactory, whereas most patients (81%) reported increased satisfaction with care provided after IMPD was included in their medication process. CONCLUSIONS: IMPD demonstrated satisfactory characteristics that were deemed positive by hospital pharmacy departments, nursing departments and patients.