Implementing a Cold Chain System Ensuring Cost

Effectiveness and Reducing Unused Dispensed

Chemotherapy

Sue Hull

Helen Wilkinson

Introduction and Background

Clatterbridge Centre for Oncology (CCO) treats patients within the Merseyside and Cheshire network Region.

CCO covers a number of clinics both in-house and at Network Hospitals.

The Pharmacy Department supplies Systemic Anti-Cancer Treatment to these clinics.

Chemotherapy is prepared in advance and taken to the clinics by CCO Nursing Staff where patients are then seen by CCO Consultants.

A review of Chemotherapy Services which resulted in repatriation of patients to network clinics, showed an increased use of High Cost Drugs being administered outside of CCO

In order to allow patients to be treated closer to home and at the same time minimise any unused chemotherapy a system needed to be put into place to enable reuse of returned chemotherapy.

ImplementationTo ensure a minimal wastage of chemotherapy drugs, implementation of a Cold Chain System was introduced.

Nursing staff were brought on board with the Cold Chain Process.

Pharmacy provided fridges to all clinics, these were monitored and results recorded over a period of time to ensure validation.

Validated boxes were sourced to ensure controlled temperature during transport of cold chain chemotherapy.

Temperature loggers were also sourced for inclusion in boxes to record temperatures throughout transportation and clinic time.

The loggers were to be returned to CCO at the end of the clinic and all data downloaded and recorded.

Specific network clinics were then chosen to be piloted.

Any returned chemotherapy was documented to enable us to calculate any cost savings that could be made by reuse of the drugs once the process had been validated.

Min Temp Max temp Mean Kinetic Temp Comments

3.6˚C 8.4˚C 5.9˚C See file

3.5˚C 7˚C 4.9˚C All temps within limits

5.5˚C 8.2˚C 6.4˚C See file

4.2˚C 7.3˚C 5.5˚C All temps within limits

4.3˚C 9.2˚C 6.1˚CAll temps within limits (max @data collection at end of recording)

4.72˚C 9.77˚C 6.71˚C All clinic temps within limits (see file)

5.0˚C 9.6˚C 6.4˚CAll temps within limits (max @data collection at end of recording)

4.5˚C 7.6˚C 6.0˚C All temps within limits

5.5 12.1 7  See File

4.57 8.47 6.73All temps within limits (max @data collection at end of recording)

4.1˚C 7.0˚C 5.9˚C All temps within limits

Results

Cold chain system implemented at pilot clinics, and a reduction of unused chemotherapy obtained producing cost savings.

ReUse of Chemotherapy from Cold Chain Clinics

£0.00

£5,000.00

£10,000.00

£15,000.00

£20,000.00

£25,000.00

£30,000.00

£35,000.00

£40,000.00

Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11

Conclusion

Further network clinics were established after the pilot scheme proved sustainable, efficient and cost effective.

This is now a permanent working practice within the CCO Pharmacy Dept clinics