The pharmacist’s role in reducing infusion-related phlebitis

• Published in: American journal of health-system pharmacy Vol. 80; no. 15; pp. 974 - 983
• Main Authors: Johnson, Jessica L, Norton, Cory, Fryfogle, Erin, Fincher, Timothy K, Burmeister, Melissa A
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 21.07.2023
• Subjects: Administration, Intravenous; Humans; Infusions, Intravenous; Infusions, Parenteral; Pharmacists; Phlebitis - chemically induced; Phlebitis - prevention & control; injection site reaction; vascular access devices; catheters; phlebitis; drug-related adverse effects and adverse reactions
• ISSN: 1079-2082; 1535-2900
• DOI: 10.1093/ajhp/zxad090

Abstract Purpose Pharmacists oversee parenteral drug preparation and administration in hospitals, clinics, infusion centers, and home infusion settings. Infusion-related phlebitis (IRP), the most common complication of intravenous infusion therapy, significantly impacts therapeutic outcomes, patient satisfaction, cost of care, and provider workload. Here we review the major etiologies of IRP and describe potential pharmacological and nonpharmacological interventions for preventing and managing the condition as well as for improving vascular access health in multiple-drug administration settings. Summary Many parenterally administered drugs cause phlebitis due to mechanical, chemical, or infectious etiologies. Pharmacists can recommend nonpharmacological strategies to mitigate phlebitis, including ­judicious device selection and placement; adjustment of the drug concentration, flow rate, or formulation; infusion site rotation; and use of inline filters to minimize contaminant particulates. Pharmacological treatments for phlebitis include topical, local, and systemic anti-inflammatory and analgesic agents that can reduce symptom severity and prevent further treatment complications or delays. Conclusion Pharmacists can contribute a unique perspective to interprofessional teams tasked with making policy and formulary decisions that minimize the negative impacts of IRP on drug delivery and patient outcomes.