Manjinder Bains and colleagues present the results of a study to assess whether the use of pre-diluted solutions to treat patients with bone metastases reduces time from preparation to completion of therapy in day unit and mobile clinic settings

Aim To compare the ready-to-use and vial formulations of zoledronic acid in terms of the time taken to prepare, check and administer the infusion in nurse-led outpatient and mobile clinic settings.

Method A prospective study of adult patients receiving zoledronic acid for the treatment of bone metastases was undertaken. Timings were captured for vital steps in the administration process.

Results Assessments of 111 infusions were made. Eight infusions were excluded because patients had received concurrent chemotherapy, leaving 56 infusions in the vials arm and 47 in the ready-to-use arm. The median total time to prepare and check a dose was significantly reduced in the ready-to-use arm compared with the vials arm in the mobile unit (00:00:28 v 00:04:47; P<0.0001) and day unit (00:01:33 v 00:03:05; P<0.0001) settings. In the mobile unit setting, this translated to significant savings in total preparation and infusion (00:25:11 v 00:32:50; P=0.0015). However, in the day unit setting, no difference in the arms was apparent (00:36:01 v 00:35:46; P=0.6169).

Conclusion The ready-to-use formulation of zoledronic acid appears to be a viable alternative to the existing vials formulation and has the potential to help practical administration of the therapy.