Impact of the subcutaneous formulations of trastuzumab and rituximab on efficiency and resource optimization in Spanish hospitals: H-Excelencia study

BMC Health Services Research

Carmen Martínez Chamorro¹  Antonio Salar²  José María Guinea De Castro³  Virginia Reguero⁴  Ainhoa Arenaza⁵  Josefa León⁶  María Reyes Abad-Sazatornil⁷  Javier Letellez⁸  Jesus García Mata⁹  Juan Bayo^1,10 

[1] Haematology Unit, Hospital Universitario Quirónsalud;Haematology Unit, Hospital de Mar;Haematology and Haemotherapy Unit, Hospital Universitario de Araba;Hospital De Cabueñes;Hospital Pharmacy, Hospital Clínico San Carlos;Hospital Pharmacy, Hospital Morales Meseguer;Hospital Pharmacy, Hospital Universitario Miguel Servet;Hospital Pharmacy, Hospital de Fuenlabrada;Medical Oncology Unit, Complexo Hospitalario Universitario de Ourense;Oncology Unit, Hospital Juan Ramón Jiménez;

关键词: Efficiency indicators;    Healthcare capacity;    Healthcare quality;    Intravenous;    Resource optimization;    Subcutaneous;   

DOI  :  10.1186/s12913-021-06277-8

来源: DOAJ

【 摘 要 】

Abstract Background Subcutaneous (SC) versus intravenous (IV) administration is advantageous in terms of patient convenience and hospital efficiency. This study aimed to compare the effect of optimizing the processes involved in SC versus IV administration of rituximab and trastuzumab on hospital capacity and service quality. Methods This cross-sectional resource utilization study interviewed oncologists, hematologists, nurses, and pharmacists from 10 hospitals in Spain to estimate changes in processes associated with conversion from IV to SC rituximab and trastuzumab, based on clinical experience and healthcare use from administrative databases. Results Efficient use of SC formulations increased the monthly capacity for parenteral administration by 3.35% (potentially increasable by 5.75% with maximum possible conversion according to the product label). The weekly capacity for hospital pharmacy treatment preparation increased by 7.13% due to conversion to SC formulation and by 9.33% due to transferring SC preparation to the cancer treatment unit (potentially increasable by 12.16 and 14.10%, respectively). Monthly hospital time decreased by 33% with trastuzumab and 47% with rituximab. In a hypothetical hospital, in which all processes for efficient use of SC rituximab and/or trastuzumab were implemented and all eligible patients received SC formulations, the estimated monthly capacity for preparation and administration increased by 23.1% and estimated hospital times were reduced by 60–66%. Conclusions Conversion of trastuzumab and rituximab to SC administration could improve the efficiency of hospitals and optimize internal resource management processes, potentially increasing care capacity and improving the quality of care by reducing time spent by patients at hospitals.

【 授权许可】

Unknown