The Effect of Pharmacist Intervention in Completing Docetaxel Infusion Within 4 Hours
Background: Docetaxel is a cytotoxic drug that have stability of 4 hours after reconstitution. The infusion must be completed within 4 hour or will result in wastage or patient receiving subtherapeutic effect drug. Aim: This study aims to determine if there is any variable in time taken to complete docetaxel infusion within 4 hour with pharmacist monitoring. Methods: A data collection form was design to record start and end time of reconstitution, preparation collected by ward staff, infusion initiation and completion. This was to identify which process that had been causing a delay in initiating infusion. In preintervention phase (Jan 2015-Jun 2015), the baseline data were traced from pharmacy records and patients chemotherapy administration charts. In postintervention phase (Jul 2015-Dec 2015), the same variables as in preintervention was collected with an additional of pharmacist intervention. Results: Analysis of collected data shows that delay in initiation of infusion is mainly due to delay in collecting reconstituted preparation by ward staff (median 30 min, IQR 13.75-45 min) and delay in initiating infusion to patient after the preparation have been collected (median 77.50 min, IQR 45-150 min). After the implementation of pharmacist intervention, the median time for ward to collect the docetaxel preparation has decreased to 25 min (IQR 20-35 min) and the median time taken from collection to start of infusion have decreased to 55 min (IQR 40-80 min). There were significant relationship in completion of docetaxel infusion within 4 hours of pharmacist intervention, χ2=5.114, P = 0.024. Conclusion: According to this result, pharmacist monitoring can significantly improve completion of docetaxel infusion within 4 hours. This study also shows that there are improvement in collection and initiation of infusion in the ward. Pharmacist infusion checking service could improve better drug utilization in the ward.