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Introduction Monoclonal antibody drugs are widely used anti-cancer therapies in the oncology outpatient setting. Increasing demand for outpatient cancer care necessitates exploration of improvements in efficiency. Limited literature has investigated the impacts of bolusing intravenous administration sets with monoclonal antibodies on chair time and associated cost. We hypothesised that bolusing IV administration sets with monoclonal antibodies would be a safe and efficient method to reduce chair time and associated cost in the oncology outpatient setting. Objectives/Aims Primary objective: To evaluate the impact on chair time and associated cost of bolusing intravenous administration sets with prescribed monoclonal antibodies, compared to a compatible fluid. A secondary objective was to assess the incidence of hypersensitivity reactions associated with this practice. Description/Methodology A randomised controlled trial (n=128), with a two-arm design (monoclonal antibody bolus versus priming with a compatible fluid i.e., 0.9% sodium chloride) at a major, quaternary hospital in metropolitan Brisbane, Australia. Included monoclonal antibodies were daratumumab, obinutuzumab, pembrolizumab and nivolumab. Cost per minute of chair time were calculated from the National Efficient Price Determination 2023 for 'chemotherapy -- treatment'. Results/Outcomes From July 2021 to January 2022, 52 patients were recruited, representing 128 episodes of care. There was a statistically significant reduction in chair time for obinutuzumab (16-minute reduction; P=0.032), pembrolizumab (7-minute reduction; P=<0.001) and nivolumab (7-minute reduction; P=<0.001) compared to priming with a compatible fluid. This led to a cost saving of $46.40, $20.30, and $20.30 (AUD) per infusion respectively, for these three monoclonal antibodies. There was no statistically significant difference in frequency of hypersensitivity reactions between study arms. Conclusion Findings suggest that bolusing IV administration sets with a prescribed monoclonal antibody drug could reduce chair time and cost in busy oncology outpatient settings. A powered study to assess the incidence of hypersensitivity reactions related to this practice is recommended. [ABSTRACT FROM AUTHOR]

Background: Improving palliative care for inpatients is urgently needed. Data from patient-reported experience measures (PREM) can assist in identifying areas for focused improvement. This study aimed to describe patient reported experience of care in inpatients with palliative care needs, to inform a baseline understanding of care experience and identify key areas for improvement., Methods: Cross-sectional study design where inpatients with palliative care needs were invited to complete 'consideRATE,' a patient reported experience measure of care, over six months in 2022. Inpatients with palliative care needs receiving care on an oncology, general medicine/renal and general medicine/respiratory ward (n = 3) at an Australian metropolitan hospital were screened for eligibility. Carers could provide proxy responses where inpatients were unable to participate. Descriptive statistics were used to analyse quantitative ratings, whilst free text responses were analysed using integrated thematic analysis., Results: One-hundred and twenty participants (108 patients and 12 carers) completed consideRATE. The questions with the highest number of 'very good' responses were attention to symptoms, attention to feelings and attention to what matters most; the questions with the lowest number of 'very good' responses was attention to patients' affairs, what to expect, and the environment of care. Almost half (n = 57, 48%) indicated that attention to patients' affairs 'did not apply' to their inpatient stay. Analysis of 532 free text responses across 8 questions highlighted the importance of feeling supported, feeling informed, feeling heard and navigating the clinical environment., Conclusion: Enabling inpatients with palliative care needs to provide feedback about their experience of care is one method of ensuring improvements matter to patients. Supporting clinical teams to understand and use these data to make tailored improvements is the next step in this multi-phase research., (© 2024. The Author(s).)