title: 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.
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.
authors.affiliation: Hôpital Saint Louis, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Xhaard
authors.affiliation: Military Institute of Medicine, Warsaw, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Rzepecki
authors.affiliation: Universitary Hospital Vall d'Hebrón, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Valcarcel
authors.affiliation: Ospedale Civile, Pescara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Santarone
authors.affiliation: Institut Paoli Calmettes, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Fürst
authors.affiliation: Hospital Universitario Gregorio Maranon, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Serrano
authors.affiliation: Universita di Roma Tor Vergata, Roma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Angelis
authors.affiliation: Universitätsmedizin Greifswald, Greifswald, Denmark.
authors.forename: W
authors.initials: W
authors.lastname: Krüger
authors.affiliation: Uniklinik Köln, Köln, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Scheid
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002066:Busulfan / Q000008:administration & dosage* / Q000493:pharmacokinetics; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration; D004334:Drug Administration Schedule; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D017060:Patient Satisfaction; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous
chemical_list: D002066:Busulfan