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    An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions?

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    Authors
    Baker J
    Dickman, A
    Mason, S
    Bickerstaff, M
    Jackson, R
    McArdle, A
    Lawrence, I
    Stephenson, F
    Paton, Nina
    Kirk, J
    Waters, B
    Ellershaw, J
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    Affiliation
    Pharmacy Department, Royal Liverpool University Hospital, Prescot Street, Liverpool
    Issue Date
    2020
    
    Metadata
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    Abstract
    Background: Continuous subcutaneous infusions (CSCIs) are commonly used in the United Kingdom as a way of administering medication to patients requiring symptom control when the oral route is compromised. These infusions are typically administered over 24 h due to currently available safety data. The ability to deliver prescribed medication by CSCI over 48 h may have numerous benefits in both patient care and health service resource utilisation. This service evaluation aims to identify the frequency at which CSCI prescriptions are altered at NHS Acute Hospitals. Methods: Pharmacists or members of palliative care teams at seven acute NHS hospitals recorded anonymised prescription data relating to the drug combination(s), doses, diluent and compatibility of CSCIs containing two or more drugs on a daily basis for a minimum of 2 days, to a maximum of 7 days. Results: A total of 1301 prescriptions from 288 patients were recorded across the seven sites, yielding 584 discrete drug combinations. Of the 584 combinations, 91% (n = 533) included an opioid. The 10 most-common CSCI drug combinations represented 37% of the combinations recorded. Median duration of an unchanged CSCI prescription across all sites was 2 days. Conclusion: Data suggests medication delivered by CSCI over 48 h may be a viable option. Before a clinical feasibility study can be undertaken, a pharmacoeconomic assessment and robust chemical and microbiological stability data will be required, as will the assessment of the perceptions from clinical staff, patients and their families on the acceptability of such a change in practice. Keywords: CSCI; Palliative therapy; Subcutaneous infusions.
    Citation
    Baker J, Dickman A, Mason S, Bickerstaff M, Jackson R, McArdle A, et al. An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? BMC Palliat Care. 2020;19(1):99.
    Journal
    Bmc Palliative Care
    URI
    http://hdl.handle.net/10541/623132
    DOI
    10.1186/s12904-020-00611-3
    PubMed ID
    32635902
    Additional Links
    https://dx.doi.org/10.1186/s12904-020-00611-3
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12904-020-00611-3
    Scopus Count
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