Using QI to develop a sustainable method for titrating taxane infusions to reduce hypersensitivity reactions.

This article focuses on the development and evaluation of a sustainable three-step titration method for administering first and second doses of taxane chemotherapies (paclitaxel and docetaxel) to reduce immediate hypersensitivity reactions (HSRs). Conducted at a large National Cancer Institute (NCI)-designated comprehensive cancer center, the quality improvement study integrated best practices in patient and environmental safety, including the use of standardized, preprogrammed infusion rates and priming intravenous tubing with inert fluid rather than hazardous drug (HD). Analysis of 1,221 taxane infusions from 690 patients showed that this sustainable method significantly lowered HSR incidence compared to non-titrated infusions (6% vs. 19%, P = 0.001) and had comparable effectiveness to a previously tested titration method that was less compliant with safety standards. The study concludes that this approach balances efficacy in reducing HSRs with adherence to regulatory safety guidelines and is recommended for routine use in ambulatory oncology settings for taxane-naïve patients receiving initial doses.