Presented By:

Julie Hoffman, ADN, RN, OCNSylvia Wentzky, ADN, RN

Bon Secours St. Francis Health System Greenville, South Carolina

The purpose of this Evidence Based Project was to compare the cost effectiveness of two anti-nausea medications: ALOXI and ZOFRAN for patients receiving highly emetogenic chemotherapy regimens, such as Cisplatin.

Bon Secours St. Francis Health System Outpatient Infusion Center

Retrospective 3 month chart review Solid tumor types 100 adult patients

Gender Age Diagnosis Types of Lung Cancer Treatments Antiemetics in Cisplatin Protocols

ALOXI- 8% Total Cost SavingsIncreased Patient SatisfactionDecreased Nursing Time

ZOFRAN-Lower Patient SatisfactionIncreased Clinic VisitsIncreased Nursing Time

Aloxi:IV push 1 dose day of chemoNursing time - 5 minutesSupplies – needle & syringe

Zofran:IVPB treatment day2 extra days of IV fluids and daily Zofran IVPBNursing time – 6.5 hoursSupplies – IV tubing

The cost analysis demonstrated that selecting Aloxi on Day 1 of the chemotherapy treatment impacted:

Cost Patient Satisfaction Nurse Time Limitations of this study included a small

sample size, retrospective nature, and selective diagnosis of Lung Cancer.

Product Availability Provider Changes & Preferences Protocol Changes

◦Dexamethasone 10 mg IVP◦Zofran 8 mg IVP◦Emend 150 mg IVPB

3 Month Retrospective Analysis (2014)◦12 Lung Cancer Patients – Cisplatin

Treatment◦1 Patient Needed Hydration

DeLeon, A. (2006, October). Palonosetron (Aloxi): A Second Generation 5HT3 Receptor Antagonist for Chemotherapy-Induced Nausea and Vomiting. Baylor University Medical Center Proceeding, 19(4),413-416. Retrieved from http:///www.medscapecom/viewarticle/512796

Feinberg, B.A., Gilmore, J., Haislip, S., Gondesen, T., Saleh, N., Lenz, W. (2009, February). Data-Driven Medical Decision-Making in Managing Chemotherapy-Induced Nausea and Vomiting, Community Oncology, 62-67. Retrieved from http://www.CommunityOncology.net

National Comprehensive Cancer Network. (2011). NCCN Clinical Practice Guilelines in Oncology (NCCN Guidelines) Antiemesis (Version 1.2012). Fort Washington, PA: Ettinger, David S., et al.

Tarricone, R., & Girolami, F. (2005). Economic Evaluation of a New Antiemetic Drug – Palonosetron Versus Ondansetron, Clinical Drug Investiation, 25 (9), 597-608 Retrieved from http://www.nci.nlm.nih.gov/pmc/articles/PMC1618755

Bon Secours St. Francis Health Bon Secours St. Francis Health SystemSystemOutpatient Infusion CenterOutpatient Infusion CenterGreenville, South CarolinaGreenville, South Carolina

JULIE HOFFMAN, ADN, RN, OCNJULIANA_HOFFMAN @BSHSI.ORG

SYLVIA WENTZKY, ADN, RNSYLVIA_WENTZKY@BSHSI.ORG

TRACY FASOLINO, PhD, FNP, ACHPNTRACY_FASOLINO@BSHSI.ORG