Aim: To evaluate the impact of a pharmacy driven protocol that converts standard rituximab infusions to subcutaneous for eligible patients.
Background: Subcutaneous rituximab has a number of advantages when compared to infusional rituximab including decreased reaction rates, flat dosing and most importantly for this study, a significantly shorter administration duration. Subcutaneous dosing of rituximab can occur in less than an hour of appointment compared to up to five hours for infusional rituximab. Maximizing the number of patients receiving subcutaneous rituximab is expected to free up chair space and nursing time and improve institutional efficiency. At this institution, change-over rates to subcutaneous dosing has been slower than expected, and this study aims to address this.
Methods: A report was compiled to identify patients receiving intravenous rituximab. This was done over two and a half months.
Inclusion criteria for eligibility: patients met PBS criteria for rituximab and they had at least 3 cycles of therapy left in their treatment cycle.19 patients were identified with 11 meeting eligibility criteria. In consultation with two hematologists and hematology clinical nurse educator, a MOSAIQ care-plan was built to incorporate the change to subcutaneous rituximab from cycle two. The pharmacist was responsible for screening eligible patients and if the consultant agreed, the subcutaneous care-plan was applied and the dose approved for supply on the treatment day.
Results: Please note that this is still ongoing. Results will be out in October'2018.