A retrospective study to evaluate the time burden associated with outpatient red blood transfusions indicated for anemia due to concomitantly administered chemotherapy in cancer patients

Abstract

PurposeAnemia in cancer patients can be treated with red blood cell (RBC) transfusions. The patient burden associated with a treatment in terms of total time spent is an important factor to consider when measuring the benefits and challenges of a therapy. This study estimates the time-related patient burden associated with outpatient RBC transfusion.MethodsA retrospective chart review of outpatient cancer patients receiving a RBC transfusion was conducted at 10 US centers. RBC transfusion time was measured as time elapsed from pre- to post-transfusion vital sign assessment and from transfusion start to stop time. Elapsed time from hemoglobin level testing and blood draw for cross-match to transfusion, estimated travel time and distance, and clinical and demographic data were also collected.ResultsData from 110 patients (48.2 % male; mean age 64 ± 12 years) showed that the mean elapsed time between pre- and post-vital sign assessment was 4.2 h (95 % confidence interval (CI), 3.64–4.81) including 3.6 h (95 % CI, 3.0–4.1) on average to receive the actual RBC transfusion treatment. Hemoglobin level testing (mean Hg level, 8.33 g/dL ± 0.67) and blood drawn for cross-match were completed in an average of 31.2 h (95 % CI, 17.0–45.5) and 18.2 h (95 % CI, 12.1–24.2) prior to transfusion, respectively. Patient one-way travel time averaged 30.0 min (95 % CI, 25.9–34.3).ConclusionsIn the US, CIA patients experience an important time burden when being treated with RBC transfusion in addition to the burden already added by chemotherapy.

Treatment complexity: a description of chemotherapy and supportive care treatment visits in patients with advanced-stage cancer diagnoses

“…Shreay and colleagues study on time burden associated with treatment for chemotherapy-induced anemia reported time to receive only a single blood transfusion per subject (mean elapsed time of 4.2 h and an additional mean time of 30 min required for oneway travel) [14]. In the study by Henry et al, subject's estimated average time per visit to treat side effects was 4.5 h [15].…”

“…One study researched time burden associated with blood transfusion for treatment of chemotherapy-induced anemia [14] and another described the treatment burden of time spent on visits made for treating side effects of chemotherapy or radiation [15]. While both studies focused on the impact of cancer treatment in terms of time burden, no study to date has attempted to describe or accurately measure a typical treatment experience, over the course of several months, for patients with advancedstage cancer.…”

Transfusions and patient burden in chemotherapy-induced anaemia in France

“…Consequently, the chart review methodology employed has also been reported elsewhere [Shreay et al 2013]. In this French cohort, 103 patients with CIA undergoing RBC transfusion were enrolled from seven treatment centres administering RBC transfusions and selected to represent the standard of care in France.…”

“…Consideration of patient burden in terms of the time spent being treated for CIA during treatment selection is a potentially important component of providing patient-centred care. Although detailed assessments of the time spent on healthcare activities associated with ESA therapy are available from multiple sources [Fortner et al 2005;Houts et al 2006;Meehan et al 2006], only a few studies have explored the care time associated with RBC transfusion, of which only one reported these outcomes from the patient perspective [Minuk et al 2008;Ueno et al 2006;Shreay et al 2013]. Two single-centre studies have reported data estimating time-based outcomes from the site perspective.…”

“…One single-centre study conducted in Canada prospectively examined the 'chair time' for 44 RBC transfusions and reported an average chair time of 231 min [standard deviation (SD) 47 min; 3.9 h; mean 2.2 RBC units transfused] [Minuk et al 2008], while the other single-centre retrospective chart review study in the USA assessed the transfusion time for 100 transfusions and reported a mean total time of 223 min (SD 54 min; 3.7 h) for a two-unit transfusion [Ueno et al 2006]. Another recent US study estimated the care time associated with RBC transfusion to treat CIA from the patient's perspective [Shreay et al 2013]. This study of 110 patients with CIA found that patients spent on average 4.2 h receiving treatment between prevital and postvital sign assessment.…”