Feasibility and Safety for Home Ambulatory Chemotherapy

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Authors (including presenting author) :
Sarah WM Lee(1), WM Ling(1), Vivian YM Ma (2), Ada LY(1), WY Au(1), SY Chan(1), SM Chan(1)
Affiliation :
(1)Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital (2)Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital
Introduction :
The incidence of cancer has significantly increased over the past decade. This dramatic increase in demand for chemotherapy service has created stress to our current medical system. To support this, a strike for change is necessary. By diverting in-patient chemotherapy to home ambulatory chemotherapy service is one of the solutions to cope with our limited in-patient resources problem.
Objectives :
The primary objective of this study was to explore the feasibility and safety for home ambulatory chemotherapy. Patient satisfaction index was another important endpoint.
Methodology :
During the period of Nov 2017 to Jun 2018, patients who underwent home ambulatory chemotherapy in our center were reviewed. Each chemotherapy episode was individually analyzed. Study parameters included final weight of ambulatory pump, estimated percentage for residue chemotherapy, duration of infusion and complications. From the period of Sep 2018 to Nov 2018, a patient satisfaction questionnaire was distributed to all patients who had home ambulatory chemotherapy experience in our center. Each questionnaire comprised of 11 essential questions. A 5-point scale was used in each question. The overall satisfaction mean score and individual question score were analyzed separately.
Result & Outcome :
A total of 29 chemotherapy episodes were analyzed. The mean final weight of the ambulatory pump and estimated percentage for residue chemotherapy were 53.2g (range 46-80.5g) and 2.3% (range -1.7 to 8.2%) respectively. 93% chemotherapy cycles finished the pump on time. There was no fast pump reported. Only 3.3% of chemotherapy cycles had pump clinking. Other complications like intravenous access blockage, dislodged pump, bubbling, leakage, skin irritation were not found. Among the 12 questionnaires received, the overall satisfaction mean score was 4.05. The lowest mean score and highest mean score for individual question were 3.67 and 4.33 respectively. Home ambulatory chemotherapy was a safe and effective way to deliver chemotherapy. Patients enjoyed high satisfaction during treatment. Such valuable service should be promoted more liberally in Hospital Authority to improve our quality of service

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