Retrospective analysis of Y-site drugs compatibilities in a hematology unit
4 October 2018G.Sicard 1, R.Fanciullino1,2, R.Costello3, S.Gensollen20 1 SMARTc, CRCM, UMR Inserm 1068, CNRS UMR 7258, Aix Marseille Université U105, Faculté de Pharmacie, 27 Boulevard Jean Moulin - CS 30064 - 13385 Marseille, France
2 Pharmacie, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille
3 Service d’hématologie, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille
In patients receiving complex infusions, knowledge and management of physical and chemical incompatibilities are essential. These interactions were found responsible for the majority of errors and / or accidents related to parenteral drug delivery. Our goals are: the development of a simple tool to help in detecting these incompatibilities and an analysis of the prescriptions of hospitalized patients in hematology department.
First, we conducted a review of the literature in order to develop a tool to detect these incompatibilities. In a second step we tested it on one year retrospective study of the prescriptions of patients hospitalized in hematology unit, receiving more than 2 different intravenous drugs.
Analysis of consumption of the hematology department, over a year, allowed us to establish the list of the most prescribed intravenous drugs: 117 drugs, 3 solvents and 1 parenteral nutrition. From this list we built a tool listing the main interactions (compatibility, incompatibility, variable compatibility) for each pair of drugs. 7381 pairs of interactions were analyzed: 1492 were compatible (20.2%), 532 were incompatible (7.2%), 71 presented a variable compatibility (1.0%) and 5286 for which the compatibilities phenomena are not described (71.6%).
When looking at the 680 prescriptions analyzed, 430 contained more than 2 different intravenous drugs, representing 15177 pairs of possible interactions. Among these pairs, 22.3% were compatible, 7.0% were incompatible, 0.4% presented variable compatibility and 70.3% compatibility is not described. We have shown that the number of incompatibilities was proportional to the number of intravenous drugs prescribed and became greater starting at 7 prescribed intravenous.
This study offered the establishment a tool to help in detecting incompatibilities and determining the critical population. In addition to the analysis of the patient’s biological data, PK / PD interactions, the development and use of this tool allows in pharmaceutical analysis to detect interactions related to the co-administration of intravenous drugs. Although these interactions are often unknown they have a major impact on patient.
Keywords: Y-site compatibility, intravenous drugs, hematology, oncology