Implications of dose rounding of chemotherapy to the nearest vial size

Dooley, Michael; Singh, Sombir; Michael, Michael

doi:10.1007/s00520-004-0606-5

Cited by 38 publications

(65 citation statements)

References 11 publications

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“…Pharmacists, rather than clinicians, may be the predominant health professionals performing this dose adjustment. 31,32 While important and interesting results have been obtained, there were a number of limitations of our study. The first of these is the modest response rate of just under 60%.…”

Section: Discussionmentioning

confidence: 88%

Chemotherapy Dosing Strategies in the Obese, Elderly, and Thin Patient: Results of a Nationwide Survey

Field

Kosmider

Jefford

et al. 2008

JOP

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Purpose: Determining the optimal starting dose of chemotherapy (CHT) presents a considerable challenge when using bodysurface area (BSA)-based dosing, particularly in obese, elderly, or thin patients. We sought to document the range of approaches employed when administering CHT to these patients. Methods Conclusion:This analysis of BSA-based CHT dosing methods demonstrates significant variability in practice. Based on evidence from adjuvant studies showing that actual BSA-based dosing is desirable, a substantial number of Australian patients are being underdosed. Further education, together with ongoing research, is required to optimize individualized dosing for efficacy and tolerability.

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Section: Discussionmentioning

confidence: 88%

Chemotherapy Dosing Strategies in the Obese, Elderly, and Thin Patient: Results of a Nationwide Survey

Field

Kosmider

Jefford

et al. 2008

JOP

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“…In such a case one vial of 400 mg plus 3 vials of 100 mg or 7 vials of 100 mg will be used. Accordingly we will save one 100 mg vial [5][6][7]. Another study applied dose rounded to chemotherapy such as oxaliplatin which is used heavily in colorectal cancer protocols.…”

Section: Fda For Non-hodgkin's Lymphoma (Nhl)mentioning

confidence: 99%

“…Authors reported the results with significant cost saving [2][3][4][5][6][7]. The most common method of calculating the dose of anticancer drugs is body surface area (BSA); a function of a patient's height and weight in addition to per weight basis.…”

mentioning

confidence: 99%

Impact of dose rounding of cancer therapy on cost avoidance: a pilot study

Ibrahim

2013

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BACKGROUND: A significant and progressive cost rising in medical oncology due to the incorporation of novel and highly expensive drugs into clinical practice have been seen in the past ten years. Dose rounding is an option might be used in oncology settings to avoid extra cost. The purpose of this project is to determine the theoretical cost saving related to a dose rounding process for biological and chemotherapy agents in adult oncology settings and to determine the opinion of oncologists about dose rounding. MATERIALS AND METHODS: Data was obtained prospectively during April 2011. All chemotherapy and targeted therapy orders prescribed in adult oncology outpatient clinics as well as in-patient wards have been collected. We considered rounding to an amount within 15% for targeted therapy and 10% for cytotoxic drugs. Chemotherapy dosing was calculated according to body surface area. Prescriptions that include cancer therapy in doses that might be rounded according to study criteria were identified. RESULTS: Two hundred and thirty three orders of chemotherapy and targeted therapy were processed by Adult Oncology Satellite Pharmacy during the period of data collection. Forty percent of the collected prescriptions fulfilled the criteria.

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“…As formulated, this double check required that an oncology pharmacist review an electronic version of the patient's prescription; make sure that the prescription given to the patient included the correctly calculated, clinically appropriate dose, which was in alignment with the previously published, internally approved chemotherapy regimens described earlier; and discuss and resolve dose discrepancies directly with the prescribing health care provider in a timely manner. A discrepancy between prescribed and intended dose of 10% or greater, a threshold based on clinical judgment and precedent, 3,4 was to prompt a telephone call and electronic message to the prescribing health care provider. In turn, the pharmacist was to provide medical record documentation that a double check had occurred with a description of outcome.…”

Section: Designing and Implementing The Safety Double Checkmentioning

confidence: 99%

Capecitabine and Temozolomide: Design, Implementation, and Preliminary Outcomes From a Pilot Project to Ensure Safe Prescribing of Oral Chemotherapy

Jatoi

Smith

Gunderson

et al. 2010

JOP

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Implications of dose rounding of chemotherapy to the nearest vial size

Abstract: The judicious application of dose rounding of chemotherapy agents is possible without any negative clinical effect. It is feasible to dose round to the nearest vial for those cytotoxic agents that are available in multiple vial sizes.

Cited by 38 publications

References 11 publications

Chemotherapy Dosing Strategies in the Obese, Elderly, and Thin Patient: Results of a Nationwide Survey

Chemotherapy Dosing Strategies in the Obese, Elderly, and Thin Patient: Results of a Nationwide Survey

Impact of dose rounding of cancer therapy on cost avoidance: a pilot study

Capecitabine and Temozolomide: Design, Implementation, and Preliminary Outcomes From a Pilot Project to Ensure Safe Prescribing of Oral Chemotherapy

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