Cost-consequences analysis of increased utilization of triple-chamber-bag parenteral nutrition in preterm neonates in seven European countries

Kriz, A.; Wright, A.; Paulsson, M.; Tomlin, S.; Simchowitz, V.; Senterre, Thibault; Shepelev, J.

doi:10.3390/nu12092531

Article (Scientific journals)

Cost-consequences analysis of increased utilization of triple-chamber-bag parenteral nutrition in preterm neonates in seven European countries

Kriz, A.; Wright, A.; Paulsson, M. et al.

2020 • In Nutrients, 12 (9), p. 1-17

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/250417

DOI
10.3390/nu12092531

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32825528

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Keywords :

Compounding errors; Cost-consequence analysis; Parenteral nutrition; Preterm neonates; Ready-to-use three-chamber-bags

Abstract :

[en] The safety of parenteral nutrition (PN) remains a concern in preterm neonates, impacting clinical outcomes and health-care-resource use and costs. This cost-consequence analysis assessed national-level impacts of a 10-percentage point increase in use of industry-prepared three-chamber bags (3CBs) on clinical outcomes, healthcare resources, and hospital budgets across seven European countries. A ten-percentage-point 3CB use-increase model was developed for Belgium, France, Germany, Italy, Portugal, Spain, and the UK. The cost-consequence analysis estimated the impact on compounding error harm and bloodstream infection (BSI) rates, staff time, and annual hospital budget. Of 265,000 (52%) preterm neonates, 133,000 (52%) were estimated to require PN. Baseline compounding methods were estimated as 43% pharmacy manual, 16% pharmacy automated, 22% ward, 9% outsourced, 3% industry provided non-3CBs, and 7% 3CBs. A modeled increased 3CB use would change these values to 39%, 15%, 18%, 9%, 3%, and 17%, respectively. Modeled consequences included −11.6% for harm due to compounding errors and −2.7% for BSIs. Labor time saved would equate to 41 specialized nurses, 29 senior pharmacists, 26 pharmacy assistants, and 22 senior pediatricians working full time. Budget impact would be a €8,960,601 (3.4%) fall from €260,329,814 to €251,369,212. Even a small increase in the use of 3CBs in preterm neonates could substantially improve neonatal clinical outcomes, and provide notable resource and cost savings to hospitals. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Disciplines :

Pediatrics

Author, co-author :

Kriz, A.; Executive Insight AG, Zurich, 8008, Switzerland

Wright, A.; Maverex Ltd., Newcastle upon Tyne, NE6 2HL, United Kingdom

Paulsson, M.; Department of Women’s and Children’s Health, Uppsala University, Uppsala, 751 85, Sweden

Tomlin, S.; Great Ormond Street Hospital, London, WC1N 3JH, United Kingdom

Simchowitz, V.; Great Ormond Street Hospital, London, WC1N 3JH, United Kingdom

Senterre, Thibault ; Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique

Shepelev, J.; Baxter Healthcare Ltd., Compton, RG20 7QW, United Kingdom

Language :

English

Title :

Cost-consequences analysis of increased utilization of triple-chamber-bag parenteral nutrition in preterm neonates in seven European countries

Publication date :

2020

Journal title :

Nutrients

ISSN :

2072-6643

Publisher :

MDPI AG

Volume :

Issue :

Pages :

1-17

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

Baxter Healthcare Corporation

Available on ORBi :

since 31 August 2020

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Bibliography

Preterm Birth. Available online: https://www.who.int/news-room/fact-sheets/detail/preterm-birth (accessed on 11 May 2020).
Martin, J.A.; Hamilton, B.E.; Osterman, M.J.K. Births in the United States, 2016. NCHS Data Brief. 2017, 287, 1–8.
Zeitlin, J.; Szamotulska, K.; Drewniak, N.; Mohangoo, A.D.; Chalmers, J.; Sakkeus, L.; Irgrens, L.; Gatt, M.; Gissler, M.; Blondel, B.; et al. Preterm birth time trends in Europe: A study of 19 countries. BJOG 2013, 120, 1356–1365.
What Are the Risk Factors for Preterm Labor and Birth? Available online: https://www.nichd.nih.gov/health/topics/preterm/conditioninfo/who_risk (accessed on 11 May 2020).
Liu, L.; Oza, S.; Hogan, D.; Chu, Y.; Perin, J.; Zhu, J.; Lawn, J.E.; Cousens, S.; Mathers, C.; Black, R.E. Global, regional, and national causes of under-5 mortality in 2000–15: An updated systematic analysis with implications for the Sustainable Development Goals. Lancet 2016, 388, 3027–3035.
WHO. Survive and Thrive: Transforming Care for Every Small and Sick Newborn; World Health Organization: Geneva, Switzerland, 2019.
Cheong, J.L.; Doyle, L.W.; Burnett, A.C.; Lee, K.J.; Walsh, J.M.; Potter, C.R.; Treyvaud, K.; Thompson, D.K.; Olsen, J.E.; Andreson, P.J.; et al. Association between moderate and late preterm birth and neurodevelopment and social-emotional development at age 2 years. JAMA Pediatr. 2017, 171, e164805.
Class. Q.A.; Rickert, M.E.; Lichtenstein, P.; D'Onofrio, B.M. Birth weight, physical morbidity, and mortality: A population-based sibling-comparison study. Am. J. Epidemiol. 2014, 179, 550–558.
Pyhälä, R.; Wolford, E.; Kautiainen, H.; Andresson, S.; Bartmann, P.; Baumann, N.; Brubakk, A.M.; Evensen, K.A.I.; Hovi, P.; Kajantie, E.; et al. Self-reported mental health problems among adults born preterm: A meta-analysis. Pediatrics 2017, 139, e20162690.
Chawanpaiboon, S.; Vogel, J.P.; Moller, A.-B.; Lumbiganon, P.; Petzold, M.; Hogan, D.; Landoulsi, S.; Jampathong, N.; Kongwattanakul, K.; Laopaiboon, M.; et al. Global, regional, and national estimates of levels of preterm birth in 2014: A systematic review and modelling analysis. Lancet Glob. Health 2019, 7, E37–E46.
Marzouk, A.; Filipovic-Pierucci, A.; Baud, O.; Tsatsaris, V.; Ego, A.; Charles, M.A.; Goffinet, F.; Evain-Brion, D.; Durand-Zaleski, I. Prenatal and post-natal cost of small for gestational age infants: A national study. BMC Health Serv. Res. 2017, 17, 221.
Darmaun, D.; Lapillonne, A.; Simeoni, U.; Picaud, J.C.; Roze, J.C.; Saliba, E.; Bocquet, A.; Chouraqui, J.P.; Dupont, C.; Feillet, F.; et al. Parenteral nutrition for preterm infants: Issues and strategy. Arch. Pediatr. 2018, 25, 286–294.
Senterre, T. Practice of enteral nutrition in very low birth weight and extremely low birth weight infants. World Rev. Nutr. Diet. 2014, 110, 201–114.
Senterre, T.; Lapillonne, A. The low birthweight infant: Inpatient care. In Nutrition in Pediatrics: Basic Science and Clinical Application, 5th ed.; Duggan, C., Watkins, J.B., Koletzko, B., Walker, W.A., Eds.; People’s Medical Publishing House: Shelton, CT, USA, 2016; pp. 539–553.
Senterre, T.; Terrin, G.; De Curtis, M.; Rigo, J. Parenteral nutrition in premature infants. In Textbook of Pediatric Gastroenterology, Hepatology and Nutrition: A Comprehensive Guide to Practice; Guandalini, S., Dhawan, A., Branski, D., Eds.; Springer International Publishing: Basel, Switzerland, 2016; pp. 73–86.
Lapillonne, A.; Carnielli, V.P.; Embleton, N.D.; Mihatsch, W. Quality of newborn care: Adherence to guidelines for parenteral nutrition in preterm infants in four European countries. BMJ Open 2013, 3, e003478.
Institute for Safe Medication Practices. ISMP List of High-Alert Medications in Acute Care Settings. Available online: https://www.ismp.org/sites/default/files/attachments/2018-08/highAlert2018-Acute-Final.pdf (accessed on 10 August 2020).
2018–2019 Targeted Medication Safety Best Practices for Hospitals. Available online: https://www.ismp.org/sites/default/files/attachments/2019-01/TMSBP-for-Hospitalsv2.pdf (accessed on 11 May 2020).
Keers, R.N.; Williams, S.D.; Cooke, J.; Ashcroft, D.M. Causes of medication administration errors in hospitals: A systematic review of quantitative and qualitative evidence. Drug Saf. 2013, 36, 1045–1067.
Boullata, J.I.; Guenter, P.; Mirtallo, J.M. A parenteral nutrition use survey with gap analysis. JPEN J. Parenter. Enteral. Nutr. 2013, 37, 212–222.
Flynn, E.A.; Pearson, R.E.; Barker, K.N. Observational study of accuracy in compounding i.v. admixtures at five hospitals. Am. J. Health Syst. Pharm. 1997, 54, 904–912.
Ayers, P.; Adams, S.; Boullata, J.; Gervasio, J.; Holcombe, B.; Kraft, M.D.; Marshall, N.; Neal, A.; Sacks, G.; Seres, D.S.; et al. A.S.P.E.N. Parenteral nutrition safety consensus recommendations. JPEN J. Parenter. Enter. Nutr. 2014, 38, 296–333.
Dickson, L.B.; Somani, S.M.; Herrmann, G.; Abramowitz, P.W. Automated compounder for adding ingredients to parenteral nutrient base solutions. Am. J. Hosp. Pharm. 1993, 50, 678–682.
Hoang, V.; Sills, J.; Chandler, M.; Busalani, E.; Clifton-Koeppel, R.; Modanlou, H.D. Percutaneously inserted central catheter for total parenteral nutrition in neonates: Complications rates related to upper versus lower extremity insertion. Pediatrics 2008, 121, e1152–e1159.
Pontes-Arruda, A.; Zaloga, G.; Wischmeyer, P.; Turpin, R.; Liu, F.X.; Mercaldi, C. Is there a difference in bloodstream infections in critically ill patients associated with ready-to-use versus compounded parenteral nutrition? Clin. Nutr. 2012, 31, 728–734.
Turpin, R.; Canada, T.; Rosenthal, V.D.; Nitzki-George, D.; Liu, F.X.; Mercaldi, C.J.; Pontes-Arruda, A. Bloodstream infections associated with parenteral nutrition preparation methods in the United States: A retrospective, large database analysis. JPEN J. Parenter. Enter. Nutr. 2011, 36, 169–176.
Instruction DGOS/PF2/DGS/PP2 no 2015-85 du 20 Mars 2015 Relative à la Gestion des Risques Liée à L’activité de Nutrition Parentérale en Réanimation Néonatale, en Néonatalogieet en Pédiatrie par la Mise en Place de Bonnes Pratiques Organisationnelles. Available online: https://solidarites-sante.gouv.fr/fichiers/bo/2015/15-04/ste_20150004_0000_0056.pdf (accessed on 11 May 2020).
The Provision of Parenteral Nutrition within Neonatal Services—A Framework for Practice. Available online: https://hubble-live assets.s3.amazonaws.com/bapm/attachment/file/57/Parenteral_Nutrition_April_2016.pdf (accessed on 11 May 2020).
Kochevar, M.; Guenter, P.; Holcombe, B.; Malone, A.; Mirtallo, J.M. ASPEN statement on parenteral nutrition standardization. JPEN J. Parenter. Enter. Nutr. 2007, 31, 441–448.
Riskin, A.; Picaud, J.-C.; Shamirc, R. The ESPGHAN/ESPEN/ESPR/CSPEN working group on pediatric parenteral nutrition ESPGHAN/ESPEN/ESPR Guidelines on pediatric parenteral nutrition: Standard versus individualized parenteral nutrition. Clin. Nutr. 2018, 37, 2409–2417.
Rigo, J.; Marlowe, M.L.; Bonnot, D.; Senterre, T.; Lapillonne, A.; Kermorvant-Duchemin, E.; Hascoet, J.M.; Desandes, R.; Malfilâtre, G.; Pladys, P.; et al. Benefits of a new pediatric triple-chamber bag for parenteral nutrition in preterm infants. J. Pediatr. Gastroenterol. Nutr. 2012, 54, 210–217.
Rigo, J.; Senterre, T. Intrauterine growth rates can be achieved in preterm infants with an industrialized premixed parenteral nutrition solution. J. Nutr. 2013, 143 (Suppl. S12), 2066S–2070S.
Evering, V.H.; Andriessen, P.; Duijsters, C.E.; Brogtrop, J.; Derijks, L.J. The effect of individualized versus standardized parenteral nutrition on body weight in very preterm infants. J. Clin. Med. Res. 2017, 9, 339– 344.
Späth, C.; Zamir, I.; Sjöström, E.S.; Domellöf, M. Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants. J. Parenter. Enter. Nutr. 2020, 44, 327–336.
Arnell, H.; Vall, F.V.; Malfilatre, G.; Pladys, P.; Senterre, T.; Pontes-Arruda, A. Safety of a triple-chamber bag parenteral nutrition in children aged up to 24 months: An observational study. J. Pediatr. Gastroenterol. Nutr. 2019, 69, e151–e157.
National Institute for Health and Care Excellence. Neonatal Parenteral Nutrition. [E] Standardized Neonatal Parenteral Nutrition Formulations. Available online: https://www.nice.org.uk/guidance/ng154/documents/evidence-review-15 (accessed on 10 August 2020).
Live Births and Crude Birth Rate Available online: https://ec.europa.eu/eurostat/databrowser/view/tps00204/default/table?lang=en (accessed on 11 May 2020).
Poets, C.F.; Wallwiener, D.; Vetter, K. Risks associated with delivering infants 2 to 6 weeks before term— A review of recent data. Dtsch. Arztebl. Int. 2012, 109, 721–726.
Indicateurs de Santé Périnatale. Available online: https://www.scansante.fr/applications/indicateurs-de-sante-perinatale (accessed on 11 May 2020).
Blondel, B.; Lelong, N.; Kermarrec, M.; Goffinet, F.; National Coordination Group of the National Perinatal Surveys. Trends in perinatal health in France from 1995 to 2010. Results from the French National Perinatal Surveys. J. Gynecol. Obstet. Biol. Reprod. 2012, 41, e1–e15.
Analisi Dell’evento Nascita—Anno 2013. Available online: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2431_allegato.pdf (accessed on 11 May 2020).
Direção de Serviços de Informação e Análise (DSIA), Direção de Serviços de Prevenção da Doença e Promoção da Saúde (DSPDPS). In Saúde Infantil e Juvenil; Ministério da Saúde: Lisbon, Portugal, 2018.
Geboortecijfer en Vruchtbaarheidscijfer Blijven Dalen. Available online: https://statbel.fgov.be/en/news/still-declining-birth-rate-and-fertility-rate (accessed on 11 May 2020).
Birth Characteristics in England and Wales: 2017. Available online: https://www.ons.gov.uk/releases/birthcharacteristicsinenglandandwales2017 (accessed on 11 May 2020).
Walter, E.; Liu, F.X.; Maton, P.; Storme, T.; Perrinet, M.; Von Delft, O.; Puntis, J.; Hartigan, D.; Dragosits, A.; Sondhi, S. Cost analysis of neonatal and pediatric parenteral nutrition in Europe: A multi-country study. Eur. J. Clin. Nutr. 2012, 66, 639–644.
Walter, E.; Maton, P.; Dragosits, A.; Sondhi, S.; Turpin, R.; Liu, F.X. Cost analysis of total parenteral nutrition in the neonatal and pediatric care in Belgian hospitals. Value Health 2011, 14, A107; abstr PIH11.
Bateman, R.; Donyai, P. Errors associated with the preparation of aseptic products in UK hospital pharmacies: Lessons from the national aseptic error reporting scheme. Qual. Saf. Health Care 2010, 19, e29.
Hicks, R.W.; Becker, S.C.; Chuo, J. A summary of NICU fat emulsion medication errors and nursing services. Adv. Neonatal Care 2007, 7, 299–308.
Pichard, C.; Schwarz, G.; Frei, A.; Kyle, U.; Jolliet, P.; Morel, P.; Romand, J.-A.; Sierro, C. Economic investigation of the use of three-compartment total parenteral nutrition bag: Prospective randomized unblinded controlled study. Clin. Nutr. 2000, 19, 245–251.
Berlana, D.; Almendral, M.A.; Abad, M.R.; Fernández, A.; Torralba, A.; Peris, M.C.; Piñeiro, G.; Romero-Jiménez, R.; Vázquez, A.; Ramírez, E.; et al. Cost, time, and error assessment during preparation of parenteral nutrition: Multichamber bags versus hospital-compounded bags. JPEN J. Parenter. Enter. Nutr. 2019, 43, 557–565.
Votre Salaire. Available online: https://votresalaire.be (accessed on 11 May 2020).
Rey, J.-B.; Andry, M.-C. Pediatric parenteral nutrition: Are Pediaven® bags more expensive? Nutr. Clin. Métabolisme 2008, 22, 108–112.
Pharma4U: Die Platform für Pharmazeuten. Available online: https://www.pharma4u.de (accessed on 11 May 2020).
AUSL della Romagna. Available online: https://www.ausl.rn.it/(accessed on 11 May 2020).
nhsjobs.com. Available online: https://www.nhsjobs.com (accessed on 11 May 2020).
Ordem dos Farmacêuticos. Available online: https://www.ordemfarmaceuticos.pt (accessed on 11 May 2020).
Sindicato Asambleario de Sanidad. Available online: https://www.sasmadrid.org (accessed on 11 May 2020).
Payne, N.R.; Carpenter, J.H.; Badger, G.J.; Horbar, J.D.; Rogowski, J. Marginal increase in cost and excess length of stay associated with nosocomial bloodstream infections in surviving very low birth weight infants. Pediatrics 2004, 114, 348–355.
Karnon, J.; McIntosh, A.; Dean, J.; Bath, P.; Hutchinson, A.; Oakley, J.; Thomas, N.; Pratt, P.; Freeman-Parry, L.; Karsh, B.-T.; et al. Modelling the expected net benefits of interventions to reduce the burden of medication errors. J. Health Serv. Res. Policy 2008, 13, 85–91.
2016/17 Reference Costs. Available online: https://improvement.nhs.uk/resources/reference-costs/(accessed on11 May 2020).
Evaluation des Pratiques en Matière de Nutrition Parentérale Pédiatrique. Available online: http://www.igas.gouv.fr/IMG/pdf/2014-168R.pdf (accessed on 11 May 2020).
Senterre, T.; Rigo, J. Optimizing early nutritional support based on recent recommendations in VLBW infants and postnatal growth restriction. J. Pediatr. Gastroenterol. Nutr. 2011, 53, 536–542.
Senterre, T.; Rigo, J. Reduction of postnatal cumulative nutritional deficit and improvement of growth in extremely preterm infants. Acta Paediatr. 2012, 101, e64–e70.
Senterre, T.; Abu Zahirah, I.; Pieltain, C.; de Halleux, V.; Rigo, J. Electrolytes and minerals homeostasis after optimizing early nutritional intakes in VLBW infants on parenteral nutrition. J. Pediatr. Gastroenterol. Nutr. 2015, 61, 491–498.
Mena, K.D.R.; Espitia, O.L.P.; Bergara, J.A.D. Management of ready-to-use parenteral nutrition in newborns: Systematic review. J. Parenteral. Enter. Nutr. 2018, 42, 1123–1132.
Gallagher, V.; Berlana, D.; Paulsson, M.; White, R.J. Parenteral nutrition: A call to action for harmonization of policies to increase patient safety. Eur. J. Clin. Nutr. 2020, doi:10.1038/s41430-020-0669-5.