Compliance, satisfaction, and quality of life of patients with colorectal cancer receiving home chemotherapy or outpatient treatment: a randomised controlled trial

Borràs, J M

doi:10.1136/bmj.322.7290.826

Cited by 130 publications

(106 citation statements)

References 15 publications

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“…There are studies in which chemotherapy appears to enhance patients' quality of life (Thatcher et al, 1997;Stockler et al, 1998;Tannock, 1998;Geels et al, 2000;Doyle et al, 2001). Ramirez et al (1998) found that only 25% of the patients benefited from chemotherapy in her study, and there are several studies in which no improvement or even deterioration of quality of life was reported (Quantin et al, 2000;van Andel et al, 2000;Barras et al, 2001;Schiller et al, 2001). Values of patients thus become more important.…”

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confidence: 96%

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

et al. 2003

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In palliative cancer treatment, the choice between palliative chemotherapy and best supportive care may be difficult. In the decisionmaking process, giving information as well as patients' values and preferences become important issues. Patients, however, may have a treatment preference before they even meet their medical oncologist. An insight into the patient's decision-making process can support clinicians having to inform their patients. Patients (n ¼ 207) with metastatic cancer, aged 18 years or older, able to speak Dutch, for whom palliative chemotherapy was a treatment option, were eligible for the study. We assessed the following before they consulted their medical oncologist: (1) socio-demographic characteristics, (2) disease-related variables, (3) quality-of-life indices, (4) attitudes and (5) preferences for treatment, information and participation in decision-making. The actual treatment decision, assessed after it had been made, was the main study outcome. Of 207 eligible patients, 140 patients (68%) participated in the study. At baseline, 68% preferred to undergo chemotherapy rather than wait watchfully. Eventually, 78% chose chemotherapy. Treatment preference (odds ratio (OR) ¼ 10.3, confidence interval (CI) 2.8 -38.0) and a deferring style of decision-making (OR ¼ 4.9, CI 1.4 -17.2) best predicted the actual treatment choice. Treatment preference (total explained variance ¼ 38.2%) was predicted, in turn, by patients' striving for length of life (29.5%), less striving for quality of life (6.1%) and experienced control over the cause of disease (2.6%). Patients' actual treatment choice was most strongly predicted by their preconsultation treatment preference. Since treatment preference is positively explained by striving for length of life, and negatively by striving for quality of life, it is questionable whether the purpose of palliative treatment is made clear. This, paradoxically, emphasises the need for further attention to the process of information giving and shared decision-making.

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confidence: 96%

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

et al. 2003

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“…Studies have shown improved QOL parameters when patients are offered ambulatory and home chemotherapy [3,22,23]. Further studies may be needed to confirm this assumption among patients from underserved communities.…”

Section: Discussionmentioning

confidence: 99%

Ambulatory high‐dose methotrexate administration among pediatric osteosarcoma patients in an urban, underserved setting is feasible, safe, and cost‐effective

Mahadeo

Santizo

Baker

et al. 2010

Pediatric Blood & Cancer

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Background. We describe the safety, feasibility, and provide a cost-estimate of outpatient high-dose methotrexate administration (HDMTX) among an urban, underserved population. Procedure. A retrospective analysis of ambulatory HDMTX administration among osteosarcoma patients, at Montefiore Medical Center's Children's Hospital (Bronx, NY) was performed. HDMTX (12 g/m 2 ) was given intravenously (IV) over 4 hr after urine alkalinization. Patients were discharged home to continue IV hydration and alkalinization delivered via a home infusion pump. Families were instructed to monitor urine pH overnight and management was adjusted according to our institution's treatment algorithm until MTX level ≤0.1 mol/L. A cost estimate was performed to assess the difference in costs for outpatient versus hypothetical inpatient administrations. Results. Of the 97 ambulatory HDMTX administrations, 99% were successfully completed. One patient failed outpatient administration secondary to home infusion pump malfunction. This patient successfully completed subsequent courses as an outpatient. Most patients (72%) had a MTX level of <10 mol/L at 24 hr post-HDMTX. No patients were found to have a MTX level of >50 mol/L at 24 hr. About 26% of courses were associated with grade III or IV neutropenia, 4% were associated with grade III or IV thrombocytopenia and 1% were associated with grade III/IV leukopenia. Compared to a hypothetical hospital inpatient stay, the hospital costs for ambulatory HDMTX were an average of $1400 less per cycle. Conclusion. Ambulatory HDMTX administration among an underserved, urban population is safe, feasible, and cost-effective. Pediatr Blood Cancer.

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“…A study comparing hospital and home antibiotic treatment for cellulitis showed that home care is the preferred treatment choice by patients, particularly for those patients who have experienced community care before [9]. In patients with colon cancer receiving chemotherapy, global patient satisfaction with health care was greater in patients receiving home chemotherapy than in patients receiving outpatient treatment [7]. In a study in patients with Fabry disease [16], most patients also preferred treatment at home.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing numbers of patients suffering from different diseases receive intravenous therapy at home including intravenous antibiotics, steroids, biphosphonates, and parenteral nutrition [8-11, 14, 17, 19, 20]. Also in cancer care, home administration of intravenous medication (chemotherapy, opiates) is becoming a widely used alternative to treatment in hospital [7,14,17]. Especially in terminally ill cancer patients, it is preferred to provide palliative care in their own environment [18,19].…”

Section: Introductionmentioning

confidence: 99%

Treatment adherence and patients’ acceptance of home infusions with adenosine 5′-triphosphate (ATP) in palliative home care

Beijer

Wijckmans

Rossum

et al. 2008

Support Care Cancer

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Goals of work In preterminal cancer patients, provision of palliative care in the patients' own environment is preferred. The aim of the present study was to evaluate patients' and caregivers' treatment adherence and patients' acceptance of home infusions with adenosine 5′-triphosphate (ATP). Patients and methods Preterminal cancer patients (life expectancy <6 months) with mixed tumor types were eligible for the study. Patients received a maximum of eight weekly intravenous 8-10 h ATP infusions. Evaluation of treatment adherence was based on registration of protocol deviations and patients' acceptance by structured interviews with patients. Main results Fifty-one patients received a total of 266 intravenous ATP infusions. The infusion protocol was well executed: mean duration ≈8.30 h, stepwise achievement of the maximum infusion rate within 30 min in 65% of the infusions, and almost no delay in weekly administration. All except one patient were not burdened by the administration of the infusions at home and none of them had felt afraid.

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Compliance, satisfaction, and quality of life of patients with colorectal cancer receiving home chemotherapy or outpatient treatment: a randomised controlled trial

Abstract: Objective To compare chemotherapy given at home with outpatient treatment in terms of colorectal cancer patients' safety, compliance, use of health services, quality of life, and satisfaction with treatment.

Cited by 130 publications

References 15 publications

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

Ambulatory high‐dose methotrexate administration among pediatric osteosarcoma patients in an urban, underserved setting is feasible, safe, and cost‐effective

Treatment adherence and patients’ acceptance of home infusions with adenosine 5′-triphosphate (ATP) in palliative home care

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