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Interactive session 2 – Chemotherapy dose banding – development and implementation

Room:

Facilitator:

Sykora, Juraj

Speakers:

Abstract:

 

Linked to EAHP Statements
Section 1 – Introductory Statements and Governance: Statements 1.2, 1.7
Section 3 – Production and Compounding: Statements 3.1, 3.2, 3.3, 3.4, 3.5
Section 4 – Clinical Pharmacy Services: Statements 4.1, 4.6, 4.7
Section 5 – Patient Safety and Quality Assurance: Statement 5.6
Section 6 – Education and Research: Statement 6.4 

ACPE UAN: 0475-0000-21-016-L07-P. A knowledge-based activity. 

Abstract
Chemotherapy dose standardisation is a system where doses of intravenous anticancer therapy calculated on an individual basis are rounded up or down to predetermined standard doses.

Historically, intravenous chemotherapy doses have been calculated for individual patients based on weight or body surface area. This led to a large number of similar, but not identical, products being made as bespoke orders within compounding units. These small product differences significantly increase time and costs of preparation and drug wastage.

Standardisation of chemotherapy doses (dose banding) offers an avenue for achieving improved value in this area with benefits for patients, providers and commissioners. The discrete dose bands lie within 6 % of the patient´s calculated dose for standard chemotherapy drugs and 10 % for biological drugs. Available products can then be standardised to match the recommended doses. There are currently 54 chemotherapy drugs with approved dose-banding tables in the UK.

Alongside standardised doses, the next step of the initiative is to standardise chemotherapy products by diluent, volume and labelling. This is the precursor to accessing ready to administer chemotherapy.

Chemotherapy dose standardisation system was developed for adult patients, but the potential impact of dose banding for systemic anti-cancer therapy in the paediatric setting based on pharmacokinetic evidence has also been investigated.

Learning objectives
After the interactive session, participants should be able to:
• recognise principles of chemotherapy dose standardisation;
• explain benefits of chemotherapy dose standardisation for patients, for physicians and other providers, for commissioners;
• implement chemotherapy dose standardisation in own practice;
• outline the next step of the initiative to standardise chemotherapy.

Educational need addressed
Hospital pharmacist should be able to identify the rationale, experience and evidence of chemotherapy dose standardisation. How to integrate oncologists in chemotherapy dose standardisation and be aware of challenges and hurdles in implementing chemotherapy dose standardisation.

Keywords: chemotherapy, dose, standardisation, dose-banding, implementation, compounding, antineoplastic agents.

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