Abstract
Previous studies have shown an equivalent pharmacokinetic profile between four-times-daily (4QD) and once-daily (QD) administration of intra-venous (IV) BU, without increased toxicity. We assess the impact of a switch in IV BU from a 4QD to a QD schedule, in terms of health-care organization, staff working conditions, quality of care dispensed and perceived patient comfort. Clinicians, nurses and pharmacists from nine allogeneic transplantation units in five European countries were interviewed face to face. Overall perception of QD versus 4QD BU was very positive. Both administration schemes were evaluated to be equally efficaciousZ. QD BU was perceived to be safer and more convenient. Clinicians and nurses perceived that patient comfort was improved, due to fewer complications associated with repeated infusions, and avoiding night infusions associated with stress, anxiety and decreased quality of sleep. Switching from 4QD to QD BU had a significant impact on health-care organization, with a better integration in the overall management and usual timelines in the pharmacies and transplantation units. Time spent to prepare and administer BU was significantly reduced, leading to potential financial savings that merit further assessment and would be of particular interest in the current economic climate.
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Acknowledgements
The authors wish to thank all participating pharmacists and nurses for their contribution to this study: Pharmacists: Isabelle Madelaine, Elżbieta Bartczak, Anna Farriols, Emanuela D'Angelo, Emmanuelle Fougereau, Norberta Sánchez, Jens Dettmann, Antje Völsgen, Hans Joachim Volk, Raffaella La Russa. Nurses: Valérie Ducollet, Katarzyna Białkowska, Mercedes Valentí, Daniela Di Nicola, Laurence Caymaris, Pilar Alonso, Veronica Molinari, Kathrin Kroggel, Christina Heinz. Special thanks to Professor Gérard Socié for his review and expertise.
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A Xhaard received honoraria from Pierre-Fabre for writing this manuscript.
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Xhaard, A., Rzepecki, P., Valcarcel, D. et al. Optimization of health-care organization and perceived improvement of patient comfort by switching from intra-venous BU four-times-daily infusions to a once-daily administration scheme in adult hematopoietic stem cell recipients. Bone Marrow Transplant 49, 509–512 (2014). https://doi.org/10.1038/bmt.2013.220
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DOI: https://doi.org/10.1038/bmt.2013.220