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Decreasing drug waste, reducing drug costs, and improving workflow efficiency through the implementation of automated chemotherapy dose rounding rules in the electronic health record system.
Shah, Vishal; Spence, Alexis; Bartels, Trace; Betcher, Jeffrey; Soefje, Scott.
  • Shah V; Department of Pharmacy, Mayo Clinic, Phoenix, AZ, USA.
  • Spence A; Department of Pharmacy, Moffitt Cancer Center, Tampa, FL, USA.
  • Bartels T; Department of Pharmacy, Moffitt Cancer Center, Tampa, FL, USA.
  • Betcher J; Department of Pharmacy, Mayo Clinic, Phoenix, AZ, USA.
  • Soefje S; Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Am J Health Syst Pharm ; 79(8): 676-682, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1597954
ABSTRACT

PURPOSE:

To decrease drug waste and cost by implementing automated chemotherapy dose rounding rules in the electronic health record (EHR). Dose rounding of chemotherapy is a recognized method for reducing drug waste, and professional organizations have published guidelines recommending dose rounding when possible.

SUMMARY:

On the basis of current literature and guideline recommendations, Mayo Clinic developed system-wide consensus to allow dose rounding for biologic and chemotherapy agents to the nearest vial size if rounding resulted in the dose being within 10% of the originally calculated dose or to a convenient measurable volume, based on concentration of the drug, if rounding to the nearest vial size resulted in the dose being outside the 10% range. Oncology pharmacists reviewed and analyzed all drugs listed in the EHR used in injectable form for the treatment of cancer and developed dose rounding rules. The rules were implemented and applied at the dose calculation stage before provider signature. From January to June 2019, approximately 40,000 cancer treatment doses were administered. The rounding rules saved a total of 9,814 vials of drug, of which 5,329 were for biologic agents and 4,485 were for oncolytic drugs. This resulted in a total 6-month cost savings of $7,284,796 (in 2019 dollars; biologics, $5,727,402; oncolytics, $1,557,394).

CONCLUSION:

Systematic implementation of dose rounding rules utilizing the EHR can result in significant reduction of drug waste and realization of savings.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Costs / Antineoplastic Agents Type of study: Prognostic study / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Am J Health Syst Pharm Journal subject: Pharmacy / Hospitals Year: 2022 Document Type: Article Affiliation country: Ajhp

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Costs / Antineoplastic Agents Type of study: Prognostic study / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Am J Health Syst Pharm Journal subject: Pharmacy / Hospitals Year: 2022 Document Type: Article Affiliation country: Ajhp