Economic and patient-reported outcomes of outpatient home-based versus inpatient hospital-based chemotherapy for patients with colorectal cancer

Joo, Eun Hye; Rha, Sun Young; Ahn, Joong Bae; Kang, Hye Young

doi:10.1007/s00520-010-0917-7

Cited by 34 publications

(35 citation statements)

References 10 publications

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“…13) Several recent comparative studies of inpatient and outpatient chemotherapy found no difference in safety between the two types of chemotherapy, but outpatient treatment reduced medical costs, by approximately 15-20%, and increased patient satisfaction. [14][15][16] Previous studies in other countries also found that the extra cost of hospital admission exceeds the costs of anti-cancer drugs and other expenses, and treating patients as outpatients reduces the total cost, consistent with our analysis.…”

Section: Discussionsupporting

confidence: 91%

A Retrospective Study of the Effects of Oncology Pharmacist Participation in Treatment on Therapeutic Outcomes and Medical Costs

Imamura

Ogawa

Takatori

et al. 2017

Biological & Pharmaceutical Bulletin

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Specialist oncology pharmacists are being trained in Japan to assist cancer treatment teams. These specialized pharmacists address patients' physical and mental problems in pharmacist-managed cancer care clinics, actively participate in formulating treatment policies, and are beneficial in offering qualitative improvements to patient services and team medical care. However, the effect of outpatient treatment by oncology pharmacists on therapeutic outcomes and medical costs is still unknown. A retroactive comparative analysis of the treatment details and clinical course was conducted among three groups of patients: patients who underwent adjuvant chemotherapy managed by a gynecologic oncologist only (S arm), patients managed by a non-oncologist (general practice gynecologist) only (NS arm), and patients managed by both a nononcologist and a specialist oncology pharmacist (NS Ph arm). The medical cost per course was significantly lower for patients in the NS Ph arm than for those in the other two arms. Surprisingly, the outpatient treatment rate in the NS Ph arm was overwhelmingly high. The involvement of an oncology pharmacist did not make a significant difference in therapeutic outcomes such as recurrence rate and survival. The participation of oncology pharmacists in the management of cancer patients undergoing chemotherapy enables safe outpatient treatment and also reduces medical costs.Key words oncology pharmacist; pharmacist-managed clinic; cancer chemotherapy; cost; outpatient treatment The development of drug therapies for cancer has resulted in improved therapeutic outcomes; these drugs play an important role in cancer treatment. However, unfortunately, cancer drugs always cause side effects, including hematological adverse events such as neutropenia and thrombocytopenia and non-hematological adverse events such as nausea, vomiting, and skin disorders. Such side effects not only diminish a patient's quality of life but may also make it difficult for the patient to continue treatment; dose adjustment, decisions on implementation, and supportive care all become important. In recent years, a policy designed to encourage outpatient treatment of cancer patients was introduced in Japan. However, satisfactory management of treatment in the outpatient setting, where there are few points of contact with patients, has been difficult, and structuring an efficient medical system is important. We established the collaborative drug therapy management (CDTM) care framework in 2008 as a method for managing joint care provided to cancer patients by physicians and specialist oncology pharmacists who address the physicians' requests. 1) In the CDTM workflow, specialist oncology pharmacists examine cancer patients at a pharmacist-managed cancer care clinic before they are seen by their attending physician, and offer proposals to the physician regarding chemotherapy management. Specialist oncology pharmacists play a major role in cancer drug therapy management, and a very high proportion of their proposals are ultimately ado...

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Section: Discussionsupporting

confidence: 91%

A Retrospective Study of the Effects of Oncology Pharmacist Participation in Treatment on Therapeutic Outcomes and Medical Costs

Imamura

Ogawa

Takatori

et al. 2017

Biological & Pharmaceutical Bulletin

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“…; Boothroyd & Lehoux ; Hirtzlin & Preaubert‐Hayes ; Bazian Ltd ; Joo et al . ; Luthi et al . ; Corrie et al .…”

Section: Resultsunclassified

“…Reducing the use of inpatient beds and ambulatory clinics for long infusions may also help create capacity and enhance value for money at the health system level (Joo et al . ; Corrie et al . ).…”

Section: Introductionmentioning

confidence: 99%

A multi-method review of home-based chemotherapy

et al. 2015

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This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes.

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“…Site of care for administration of infusions has been shown to have an impact on patients and their caregivers by affecting sense of control, ability to maintain normal daily activities (e.g., work, school, time with family), cost of care, treatment adherence, and risk of infection, regardless of disease state [ 16 , 18 , 24 – 26 ]. Treatment for patients with PIDD can be administered at different sites of care, including at a hospital outpatient infusion center or at home.…”

Section: Discussionmentioning

confidence: 99%

Impact of Site of Care on Infection Rates Among Patients with Primary Immunodeficiency Diseases Receiving Intravenous Immunoglobulin Therapy

et al. 2017

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PurposePatients with primary immunodeficiency diseases (PIDD) are at increased risk of infection and may require lifelong immunoglobulin G (IgG) replacement. Infection incidence rates were determined for patients with PIDD receiving intravenously administered IgG (IGIV) in a home or hospital outpatient infusion center (HOIC).MethodsData were extracted from a large, US-based, employer-sponsored administrative database. Patients were eligible for analysis if they had ≥1 inpatient or emergency room claim or ≥2 outpatient claims with a PIDD diagnosis between January 2002 and March 2013, 12 months of continuous health plan enrollment prior to index date (i.e., first IGIV infusion date), and 6 months of continuous IGIV at the same site of care after the index date. Incidences of pneumonia (bacterial or viral) and bronchitis (all types) within 7 days of IGIV infusion were retrospectively determined and compared between sites of care.ResultsA total of 1076 patients were included in the analysis; 51 and 49% received IGIV at home and at an HOIC, respectively. The event/patient-year of pneumonia was significantly lower in patients receiving IGIV at home compared to an outpatient hospital (0.102 vs. 0.216, p = 0.0071). Similarly, the event/patient-year of bronchitis was significantly lower among patients infusing at home compared to an HOIC (0.150 vs. 0.288, p < 0.0001).ConclusionsPIDD patients experienced incidence rates for pneumonia and bronchitis that were lower for patients receiving home-based IGIV treatment versus HOIC-based IGIV treatment. The lower infection rates in the home setting suggest that infection risk may be an important factor in site of care selection.

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Economic and patient-reported outcomes of outpatient home-based versus inpatient hospital-based chemotherapy for patients with colorectal cancer

Abstract: Higher satisfaction and lower economic cost for home-based chemotherapy suggests that home-based chemotherapy could be a popular and cost-effective treatment option for colorectal cancer patients who are eligible for home-based chemotherapy.

Cited by 34 publications

References 10 publications

A Retrospective Study of the Effects of Oncology Pharmacist Participation in Treatment on Therapeutic Outcomes and Medical Costs

A Retrospective Study of the Effects of Oncology Pharmacist Participation in Treatment on Therapeutic Outcomes and Medical Costs

A multi-method review of home-based chemotherapy

Impact of Site of Care on Infection Rates Among Patients with Primary Immunodeficiency Diseases Receiving Intravenous Immunoglobulin Therapy

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