Date, 2011—Rules-based dosing for pediatric chemotherapy
Starting January 4th, chemotherapy order entry (COE) includes pediatric treatments that utilize rules-based AUC dosing. Previously, these protocols required manual evaluation of the rules to determine which dosing standard or formula to use, then the manual calculation of the dose, which was finally written as an exception order in COE. With this major enhancement, providers are able to select the chemo medication in COE, which automatically evaluates the rules and calculates the appropriate dose.
Key features:
At present, dosing rules are built for selected pediatric protocols only. Only providers authorized for pediatric chemotherapy can order from these protocols.
Conditions for determining the dosing include one or more of the following: the patient's weight in kg, body surface area (BSA) in m2, age in months or years, glomerular filtration rate (GFR) raw or corrected.
The ordering provider is prompted for lab results to capture the patient's GFR, a key value in the calculation of pediatric AUC dosing.
When the patient meets a condition, the standard or formula dosing is applied and the dose for treatment is calculated automatically.
If the patient does not meet any of the defined conditions, the order is automatically omitted. The reason for omitting an order is saved as a general care order that includes the rules for dosing.
A selected or preselected medication can be omitted automatically by the dosing rules.
When ordering from previous where the rules set determined that a selected medication should be omitted, the ordering provider is prompted to review the need for that chemo medication. The order can be reselected for recalculation, and ordered or omitted automatically as the dosing rules indicate; alternately, the ordering provider can manually omit the order. If the order is recalculated and omitted, the prompt to re-evaluate will occur for subsequent order sessions. If the order is manually omitted, it remains so for subsequent sessions.
For chemo builders: Building Dosing Rules for Chemotherapy Medications
See also: