An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions?
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...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12904-020-00611-3 |
| _version_ | 1818891046646448128 |
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| author | J. Baker A. Dickman S. Mason M. Bickerstaff R. Jackson A. McArdle I. Lawrence F. Stephenson N. Paton J. Kirk B. Waters J. Ellershaw |
| author_facet | J. Baker A. Dickman S. Mason M. Bickerstaff R. Jackson A. McArdle I. Lawrence F. Stephenson N. Paton J. Kirk B. Waters J. Ellershaw |
| author_sort | J. Baker |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T17:34:35Z |
| format | Article |
| id | doaj.art-ae2ef81afab7438ca068342ad85622e1 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-19T17:34:35Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-ae2ef81afab7438ca068342ad85622e12022-12-21T20:12:22ZengBMCBMC Palliative Care1472-684X2020-07-011911710.1186/s12904-020-00611-3An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions?J. Baker0A. Dickman1S. Mason2M. Bickerstaff3R. Jackson4A. McArdle5I. Lawrence6F. Stephenson7N. Paton8J. Kirk9B. Waters10J. Ellershaw11Pharmacy Department, Royal Liverpool University HospitalPharmacy Department, Royal Liverpool University HospitalPalliative Care Institute Liverpool, University of LiverpoolLiverpool Clinical Trials Unit, University of LiverpoolLiverpool Clinical Trials Unit, University of LiverpoolPharmacy Department, Wirral University Teaching Hospital NHS Foundation TrustPharmacy Department, Sheffield Teaching Hospitals NHS Foundation TrustPharmacy Department, Sheffield Teaching Hospitals NHS Foundation TrustPharmacy Department, The Christie NHS Foundation TrustPharmacy Department, St Helens and Knowsley Teaching Hospitals NHS TrustPharmacy Department, Blackpool Teaching Hospitals NHS Foundation TrustPharmacy Department, Royal Liverpool University HospitalAbstract 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.http://link.springer.com/article/10.1186/s12904-020-00611-3Palliative therapySubcutaneous infusionsCSCI |
| spellingShingle | J. Baker A. Dickman S. Mason M. Bickerstaff R. Jackson A. McArdle I. Lawrence F. Stephenson N. Paton J. Kirk B. Waters J. Ellershaw An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? BMC Palliative Care Palliative therapy Subcutaneous infusions CSCI |
| title | An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? |
| title_full | An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? |
| title_fullStr | An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? |
| title_full_unstemmed | An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? |
| title_short | An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals: is there potential for 48-hour infusions? |
| title_sort | evaluation of continuous subcutaneous infusions across seven nhs acute hospitals is there potential for 48 hour infusions |
| topic | Palliative therapy Subcutaneous infusions CSCI |
| url | http://link.springer.com/article/10.1186/s12904-020-00611-3 |
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