Pharmacist-led redesign of chemotherapy delivery and supportive care: effects on infusion capacity, aseptic workload, costs and resource stewardship in oncology practice
4 affiliations
- 1Hospital Pharmacy of St. Elisabeth, St. Elisabeth Cancer Institute
- 2Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University Bratislava
- 31st Department of Oncology, Faculty of Medicine, Comenius University Bratislava and St. Elisabeth Cancer Institute
- 4Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University Bratislava
Abstract
Introduction: Medication-related processes in oncology are complex and resource intensive, creating opportunities for treatment delays, preparation burden, medication errors, and inefficient resource utilization. Pharmacist-led interventions have been associated with improvements in medication safety, efficiency, and costs, yet evidence evaluating their system-wide impact remains limited. This study evaluated an integrated pharmacist-led, multidisciplinary redesign of medication-use processes encompassing supportive medications, infusion administration, and drug preparation in a tertiary oncology center.
Materials and methods: We performed a retrospective analysis of routinely collected administration data from January to June 2023. Baseline practice (3,750 administrations) was compared with a modelled full-implementation scenario. Scheduled administration time (SAT) was used as an operational measure of infusion-unit resource use. Aseptic workload, direct acquisition costs, and assessed single-use consumable waste were estimated using prespecified model rules, measured unit weights, and 2023 institutional acquisition prices. A pragmatic February 2026 substudy compared current SAT with real administration time, reconstructed baseline equivalent SAT, and modelled full-implementation SAT.
Results: Baseline cumulative SAT was 8,945 h. IV supportive medications accounted for 1,801 SAT h and 680 h of aseptic preparation time. In the modelled full-implementation scenario, total SAT decreased by 43% (−3,851 h), aseptic workload by 666.8 h, direct acquisition costs by €20,276, and assessed single-use consumable waste by 331.6 kg. In the February 2026 substudy, current SAT closely approximated real administration time and indicated that a substantial proportion of the modelled SAT reduction had already been achieved in routine practice.
Discussion: To our knowledge, this is the first study to simultaneously quantify infusion service capacity, aseptic workload, direct costs, and consumable waste within a pharmacist-led, multidisciplinary oncology redesign framework. By streamlining medication-use processes across multiple stages of care, such interventions may contribute to safer medication delivery, improved resource stewardship, and greater infusion service capacity. This model represents a scalable and policy-relevant approach to supporting high-quality cancer care while promoting long-term healthcare sustainability.
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BibTeX
@article{dudik2026pharmacistled,
title = {{Pharmacist-led redesign of chemotherapy delivery and supportive care: effects on infusion capacity, aseptic workload, costs and resource stewardship in oncology practice}},
author = {Boris Dudík and Bela Mriňáková and Karolína Kimliková and Iveta Waczulíková and Orijana Krajčík and Zuzana Kiliánová and Natália Blažová and Stanislava Kosírová and Vanda Ušáková and Klaudia Gočárová and Ján Klimas},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1908515},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1908515/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Pharmacist-led redesign of chemotherapy delivery and supportive care: effects on infusion capacity, aseptic workload, costs and resource stewardship in oncology practice
AU - Boris Dudík
AU - Bela Mriňáková
AU - Karolína Kimliková
AU - Iveta Waczulíková
AU - Orijana Krajčík
AU - Zuzana Kiliánová
AU - Natália Blažová
AU - Stanislava Kosírová
AU - Vanda Ušáková
AU - Klaudia Gočárová
AU - Ján Klimas
PY - 2026
DA - 2026/10/28
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1908515
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1908515/full
AB - Introduction: Medication-related processes in oncology are complex and resource intensive, creating opportunities for treatment delays, preparation burden, medication errors, and inefficient resource utilization. Pharmacist-led interventions have been associated with improvements in medication safety, efficiency, and costs, yet evidence evaluating their system-wide impact remains limited. This study evaluated an integrated pharmacist-led, multidisciplinary redesign of medication-use processes encompassing supportive medications, infusion administration, and drug preparation in a tertiary oncology center. Materials and methods: We performed a retrospective analysis of routinely collected administration data from January to June 2023. Baseline practice (3,750 administrations) was compared with a modelled full-implementation scenario. Scheduled administration time (SAT) was used as an operational measure of infusion-unit resource use. Aseptic workload, direct acquisition costs, and assessed single-use consumable waste were estimated using prespecified model rules, measured unit weights, and 2023 institutional acquisition prices. A pragmatic February 2026 substudy compared current SAT with real administration time, reconstructed baseline equivalent SAT, and modelled full-implementation SAT. Results: Baseline cumulative SAT was 8,945 h. IV supportive medications accounted for 1,801 SAT h and 680 h of aseptic preparation time. In the modelled full-implementation scenario, total SAT decreased by 43% (−3,851 h), aseptic workload by 666.8 h, direct acquisition costs by €20,276, and assessed single-use consumable waste by 331.6 kg. In the February 2026 substudy, current SAT closely approximated real administration time and indicated that a substantial proportion of the modelled SAT reduction had already been achieved in routine practice. Discussion: To our knowledge, this is the first study to simultaneously quantify infusion service capacity, aseptic workload, direct costs, and consumable waste within a pharmacist-led, multidisciplinary oncology redesign framework. By streamlining medication-use processes across multiple stages of care, such interventions may contribute to safer medication delivery, improved resource stewardship, and greater infusion service capacity. This model represents a scalable and policy-relevant approach to supporting high-quality cancer care while promoting long-term healthcare sustainability.
SN - 1663-9812
ER -