Highlights
- •Peripheral administration of epirubicin can cause phlebitis.
- •Limited evidence exists for epirubicin administration methods to reduce phlebitis.
- •Infusion pump administration of epirubicin increased patient-reported phlebitis.
- •No significant difference in phlebitis severity on clinical assessment.
- •A transient increase in phlebitis severity compared to manual injection method.
Abstract
Objective
To establish the incidence and severity of chemotherapy-induced phlebitis (CIP) following
administration of epirubicin chemotherapy using a volumetric infusion pump (Hospira
Plum 360), compared to a previous study of manual injection of epirubicin. Secondly
to gain insight into staff perceptions of ease of use and safety of infusion pump
administration.
Methods
An observational study of women with breast cancer (n = 47) receiving epirubicin via
volumetric infusion pump. Phlebitis was reported through a participant self-assessment
questionnaire and graded by clinical assessment three weeks after each chemotherapy
cycle. Staff perceptions were explored using questionnaires.
Results
Infusion pump administration delivered a significantly higher concentration of epirubicin
(p < 0.001), a significantly higher rate of grade 3 and 4 participant reported CIP
between cycles (p = 0.003) but demonstrated no significant difference in grade 3 and
4 CIP when assessed clinically three weeks after treatment (p = 0.157).
Conclusion
Peripheral epirubicin administration will result in severe CIP being experienced by
a proportion of patients irrespective of whether infusion pump or manual injection
method is used. Those at high risk of severe CIP should be informed of the risk and
offered a central line. For those with a lower risk of severe phlebitis use of the
infusion pump appears to be a safe option.
Keywords
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Article info
Publication history
Accepted:
March 10,
2023
Received in revised form:
February 25,
2023
Received:
November 14,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Published by Elsevier Ltd.
