Fecha de recepción: 04/11/2017 – Fecha de aceptación: 15/01/2018
Cortell Fuster C1, Moya-Gil A1, Royo Peiró A2, Vicent Verge JM2, Bosch Roig CE2, Climente Martí M1
1 Servicio de Farmacia
2 Servicio de Oncología Médica
Hospital Universitario Dr. Peset. Valencia (España)
Clara Cortell Fuster
Hospital Universitario Dr. Peset
(Servicio de Farmacia)
Avda. Gaspar Aguilar, 90
Correo electrónico: firstname.lastname@example.org
Purpose: Evaluating the efficiency of dose banding of leucovorin calcium as a Lean tool in patients with metastatic colo-rectal cancer.
Methods: 16-month cohort ambispective study, of 12 weeks of follow-up in each group. Control retrospective group: administered dose of calcium levofolinate according to dose prescribed by body surface. Intervention prospective group: administered dose of leucovorin calcium according to dose banding. 4 batches of leucovorin calcium were developed: 175 mg and 350 mg in 100 ml and 250 ml of serum glucose 5%. Patients presenting a difference >10% between prescribed dose and dose banding were excluded. Efficiency variables: time and costs reduction in picking/compounding according to the salary of the staff of Pharmacy Department. Effectiveness variables: overall survival and progression-free survival at 12 weeks. Safety variables: adverse events associated with 5-fluorouracil treatment. The statistics analysis was made with STATA v13.1.
Results: 32 patients were included (16 in each group), 188 patients-day. Dose banding allowed a decrease of 10 min in the median time of conditioning/preparation. An annual saving of € 2,007 was estimated. There were no significant differences in overall survival and progression free survival between groups (p=1.00, in both cases). More frequent adverse events were diarrhea and weakness without differences between groups: (p=1.00 and 0.72, respectively).
Conclusions: Leucovorin calcium dose-banding is a Lean tool for efficiency improvement in chemotherapy without compromising the effectiveness and safety of antineoplastic therapy.
Key Words: Administration and dosage, dose-banding, standardization, fixed doses, levofolinate calcium, colo-rectal cancer, Lean.