Rationalisation of chemotherapy services in the University Hospital Birmingham National Health Science Trust

Abstract

Objectives. To audit chemotherapy prescribing in out-patient clinics in order to develop a novel ap proach for the provision of chemotherapy services to peripheral clinics. Method. Two audits of CMF (cyclophospha mide, methotrexate, and 5-fluorouracil) chemother apy were performed to initially determine the feasi bility and cost effectiveness of a centralised chemotherapy service. Subsequently, an audit was performed to develop a system for the rationalisation of chemotherapy prescribing using dose-banding. Results. The results from the first audit showed that of the 97 courses of chemotherapy prescribed in the peripheral out-patient clinic, 13.5% were de ferred. All deferred chemotherapy was reissued amounting to a saving of £681.00 over the 6 months studied. The second audit compiled data from 380 courses of CMF and enabled a dose-banding system to be developed. A system was devised so that an agreed 5% variance from the dose prescribed enabled pre filled chemotherapy syringes to be supplied, with no more than two syringes being used per dose. Conclusion. In conclusion, the prefilled syringe programme has improved patient waiting times, re duced drug wastage, and has enabled rationalisation of chemotherapy services in this health district.