{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:58:12Z","timestamp":1754153892083,"version":"3.41.2"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: Sugammadex, a selective relaxant binding agent, works by encapsulating rocuronium or vecuronium to reverse neuromuscular blockade. It is an asset in emergencies requiring expedient reversal of neuromuscular blockade, such as situations involving difficult airways. A prevalent concern relating to sugammadex use is its higher cost compared with traditional reversal agents, contributing to more than 20% of operating room drug expenditures at Hamilton Health Sciences (Hamilton, Ontario) in 2019\/20.\nObjective: To use iterative Plan-Do-Study-Act cycles to reduce annual sugammadex expenditure at Hamilton Health Sciences by 50% from costs in the 2020\/21 fiscal year.\nMethods: Five Plan-Do-Study-Act cycles were implemented (January to April 2021) to increase awareness about the cost of sugammadex and appropriate indications for its use. The organization\u2019s Department of Pharmacy supplied data regarding acquisition of sugammadex before, during, and after the Plan-Do-Study-Act cycles, which were analyzed quantitatively. A data set regarding difficult airways at Hamilton Health Sciences was analyzed alongside the sugammadex data to aid in understanding the need for accessibility of this drug.\nResults: Use of sugammadex in fiscal year 2021\/22 at Hamilton Health Sciences decreased by 75% from the previous fiscal year, without compromising patient safety or drug availability. Analysis of the difficult airway data revealed that both anticipated and unanticipated cases of difficult airway were still prevalent across all hospitals, which highlights the importance of maintaining access to and knowledge of how to use sugammadex in the setting of difficult airways.\nConclusions: This cost-reduction project showed that user-based program designs can have a meaningful impact on resource utilization. Additionally, the difficult airway data set emphasized the clear need to maintain availability of and capabilities for administering sugammadex, given the prevalence of emergency airway situations.\nKeywords: cost reduction, anesthesia, resources, patient safety, drug utilization review, sugammadex, hospital pharmacy service\nR\u00c9SUM\u00c9\nContexte : Le sugammadex, un agent de liaison s\u00e9lectif des relaxants, agit en encapsulant le rocuronium ou le v\u00e9curonium pour inverser le blocage neuromusculaire. Il constitue un atout pr\u00e9cieux en cas d\u2019urgence n\u00e9cessitant une inversion rapide du blocage neuromusculaire, comme dans les situations impliquant une gestion difficile des voies a\u00e9riennes. Une pr\u00e9occupation courante li\u00e9e \u00e0 l\u2019utilisation du sugammadex est son co\u00fbt plus \u00e9lev\u00e9 par rapport aux agents d\u2019inversion traditionnels. Il repr\u00e9sentait plus de 20 % des d\u00e9penses en m\u00e9dicaments des salles d\u2019op\u00e9ration de l\u2019autorit\u00e9 sanitaire Hamilton Health Sciences (\u00e0 Hamilton, en Ontario) en 2019-2020.\nObjectif : Utiliser des cycles it\u00e9ratifs Planifier-Faire-V\u00e9rifier-Agir (PFVA) pour r\u00e9duire de 50 % les d\u00e9penses annuelles de sugammadex de l\u2019autorit\u00e9 sanitaire Hamilton Health Sciences par rapport aux co\u00fbts de l\u2019exercice 2020-2021.\nM\u00e9thodologie : Cinq cycles PFVA ont \u00e9t\u00e9 mis en \u0153uvre (de janvier jusqu\u2019en avril 2021) pour sensibiliser le personnel au co\u00fbt du sugammadex et aux indications appropri\u00e9es relatives \u00e0 son utilisation. Le d\u00e9partement de pharmacie de l\u2019organisme a fourni des donn\u00e9es sur l\u2019acquisition de sugammadex avant, pendant et \u00e0 la fin de la s\u00e9rie de cycles PFVA, qui ont \u00e9t\u00e9 analys\u00e9es quantitativement. Un ensemble de donn\u00e9es concernant la gestion difficile des voies a\u00e9riennes \u00e0 l\u2019autorit\u00e9 sanitaire Hamilton Health Sciences a \u00e9t\u00e9 analys\u00e9 en parall\u00e8le avec les donn\u00e9es sur le sugammadex afin de mieux comprendre la n\u00e9cessit\u00e9 d\u2019assurer l\u2019accessibilit\u00e9 de ce m\u00e9dicament.\nR\u00e9sultats : L\u2019utilisation du sugammadex \u00e0 l\u2019autorit\u00e9 sanitaire Hamilton Health Sciences pendant l\u2019exercice 2021-2022 a diminu\u00e9 de 75 % par rapport \u00e0 l\u2019exercice pr\u00e9c\u00e9dent, sans compromettre la s\u00e9curit\u00e9 des patients ni la disponibilit\u00e9 du m\u00e9dicament. L\u2019analyse des donn\u00e9es portant sur la gestion difficile des voies a\u00e9riennes a r\u00e9v\u00e9l\u00e9 que les cas anticip\u00e9s et non anticip\u00e9s de gestion difficile demeuraient fr\u00e9quents dans tous les h\u00f4pitaux, ce qui souligne l\u2019importance de maintenir l\u2019acc\u00e8s au sugammadex et de ma\u00eetriser son utilisation dans le contexte de la gestion difficile des voies a\u00e9riennes.\nConclusions : Ce projet de r\u00e9duction des co\u00fbts a d\u00e9montr\u00e9 que des approches centr\u00e9es sur les utilisateurs peuvent avoir des cons\u00e9quences importantes sur l\u2019utilisation des ressources. Par ailleurs, l\u2019analyse des donn\u00e9es relatives \u00e0 la gestion difficile des voies a\u00e9riennes a mis en \u00e9vidence la n\u00e9cessit\u00e9 ind\u00e9niable de maintenir la disponibilit\u00e9 du sugammadex et les comp\u00e9tences pour son administration, compte tenu de la fr\u00e9quence des situations d\u2019urgence impliquant des voies a\u00e9riennes.\nMots-cl\u00e9s : r\u00e9duction des co\u00fbts, anesth\u00e9sie, ressources, s\u00e9curit\u00e9 des patients, examen de l\u2019utilisation des m\u00e9dicaments, sugammadex, service de pharmacie hospitali\u00e8re<\/jats:p>","DOI":"10.4212\/cjhp.3648","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T13:38:55Z","timestamp":1741786735000},"source":"Crossref","is-referenced-by-count":0,"title":["Reducing Sugammadex Expenditure through Educational Initiatives in an Urban Tertiary Care Hospital System: A Cost-Reduction Study"],"prefix":"10.4212","volume":"78","author":[{"given":"Erin","family":"Ingoldsby","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Romeril","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tal","family":"Levit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekta","family":"Khemani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2025,2,12]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3648\/5525","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3648\/5531","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3648\/5525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T16:59:34Z","timestamp":1753289974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3,12]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3648","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"type":"electronic","value":"1920-2903"},{"type":"print","value":"0008-4123"}],"subject":[],"published":{"date-parts":[[2025,2,12]]},"article-number":"e3648"}}