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Pallaro S, Bigas M, Leobon S, Baffert KA, Peyramaure C, Dubest L, Venat L, Maillan G, Deluche É. [Administration of anti-HER2 and satisfaction of patients treated for breast cancer]. Bull Cancer 2024; 111:441-451. [PMID: 38480056 DOI: 10.1016/j.bulcan.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/15/2023] [Accepted: 01/01/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION Quality of life (QoL) and patient satisfaction are major concerns in oncology. METHODS The aim of this prospective observational study was to evaluate these parameters according to the mode of administration of anti-HER2 (subcutaneous [SC] versus intravenous [IV]), the place of administration (Home Hospitalization or HOD versus hospital) for patients supervised by an advanced practice nurse (APN). RESULTS Between January 2022 and June 2023, 32 patients were included. They were statistically more satisfied with subcutaneous management (P=0.0004), a result explained by the speed of administration (43.5%), comfort during administration (26%) even though some expressed pain on injection and felt less anxiety (26%). Management by the APN seems more appropriate when anti-HER2 drugs were administered in HOD. In HOD, patients perceived an overall improvement in their quality of life, appetite and cognitive abilities, with a reduction in fatigue, pain and depression (P<0.05). However, the rate of outsourcing to HOD remained too low (30.4%), as 56.3% of patients would have liked to be cared for in HOD if they had had the opportunity. CONCLUSION SC administration of anti-HER2 under the supervision of an APN has advantages for the patient, resulting in greatest satisfaction and improved patient QOL, preferably in HOD.
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Affiliation(s)
- Solène Pallaro
- Unité de préparation des anticancéreux, CHU de Limoges, Limoges, France
| | - Marion Bigas
- Service d'oncologie médicale, CHU de Limoges, Limoges, France
| | - Sophie Leobon
- Service d'oncologie médicale, CHU de Limoges, Limoges, France
| | | | | | - Laurence Dubest
- Service d'oncologie médicale, CHU de Limoges, Limoges, France
| | - Laurence Venat
- Service d'oncologie médicale, CHU de Limoges, Limoges, France
| | - Gaëlle Maillan
- Unité de préparation des anticancéreux, CHU de Limoges, Limoges, France
| | - Élise Deluche
- Service d'oncologie médicale, CHU de Limoges, Limoges, France.
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Impacts on health outcomes and on resources utilization for anticancer drugs injection at home, a complex intervention: a systematic review. Support Care Cancer 2021; 29:5581-5596. [PMID: 33763728 DOI: 10.1007/s00520-021-06145-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND As hospital-based home care is a complex intervention, we critically appraised the key elements that could ensure the completeness of assessment and explain the heterogeneity of the literature results about the comparison between home and hospital setting for the anticancer drugs injection within the same standards of clinical care. METHODS Systematic review was conducted. Medline, Embase, Cochrane Library, Web of Sciences, and Cumulative Index of Nursing and Allied Health (Cinahl) searched to February 1, 2019, and combined with grey literature. Methodological quality has been rated using the "Quality Assessment Tool for Quantitative Studies" developed by the Effective Public Health Practice Project (EPHHP) in addition to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement for economic studies and the consolidated criteria for reporting qualitative research (COREQ) checklist for qualitative studies. RESULTS Of 400 records identified, we identified 13 relevant studies (nine quantitative and four mixed-method studies). The quality of studies was hardly strong. The home-based anticancer injection involved highly heterogeneous home care interventions that generally kept a strong link with the hospital setting. The study schemes limited the comparison of clinical outcomes (OS, PFS, toxicity). Unlike the quality of life remaining similar, patients preferred to be treated at home. Cost savings were in favor of Hospital at Home, but the charge categories used to compare or the home intervention were heterogeneous and rarely integrating relatives' duties and hospital staff's time. Qualitative studies highlighted about benefits and barriers of home. CONCLUSION The current state of evidence shows as it still remains difficult to appraise the anticancer injection at home when considering the details of this complex intervention, the role of each stakeholder, and the missing data.
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Pailler C, Chapot T, Softa S, Gandrille N, Ruiz D, Mathieu S, Delaloge S. Administration de trastuzumab par voie sous-cutanée à domicile : retour d’expérience des patientes traitées en 2016 par l’hospitalisation à domicile Santé Service. Bull Cancer 2018; 105:1126-1134. [DOI: 10.1016/j.bulcan.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 10/02/2018] [Accepted: 10/02/2018] [Indexed: 11/16/2022]
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Touati M, Lamarsalle L, Moreau S, Vergnenègre F, Lefort S, Brillat C, Jeannet L, Lagarde A, Daulange A, Jaccard A, Vergnenègre A, Bordessoule D. Cost savings of home bortezomib injection in patients with multiple myeloma treated by a combination care in Outpatient Hospital and Hospital care at Home. Support Care Cancer 2016; 24:5007-5014. [PMID: 27525991 PMCID: PMC5082582 DOI: 10.1007/s00520-016-3363-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Abstract
At home injectable chemotherapy for patients receiving treatment for hematological diseases is still in debate. Given the expense of new innovative medicines, at home treatment has been proposed as a suitable option for improving patient quality of life and decreasing treatment costs. We decided to assess the cost of bortezomib administration in France among multiple myeloma patients from an economic standpoint. Patients in this study were treated within a regional hematological network combining outpatient hospital care and Hospital care at Home administration. To make the cost comparison, our team simulated outpatient hospital care expenses. Fifty-four consecutive multiple myeloma patients who received at least one injection of bortezomib in Hospital care at Home from January 2009 to December 2011 were included in the study. The median number of injections was 12 (range 1–44) at home and 6 (range 0–30) in the outpatient care unit. When compared with the cost simulation of outpatient hospital care alone, bortezomib administration with combined care was significantly less expensive for the National Health Insurance (NHI) budget. The mean total cost per patient and per injection was 954.20 € for combined outpatient and Hospital care at Home vs 1143.42 € for outpatient hospital care alone. This resulted in an estimated 16.5 % cost saving (Wilcoxon signed-rank test, p < 0.0001). The greatest savings were observed in administration costs (37.5 % less) and transportation costs (68.1 % less). This study reflects results for a regionally implemented program for multiple myeloma patients treated with bortezomib in routine practice in a large rural area.
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Affiliation(s)
- Mohamed Touati
- Service d'Hématologie Clinique et Thérapie Cellulaire, CHU de Limoges, Limoges, France. .,Réseau HEMATOLIM, CHU de Limoges, Limoges, France.
| | | | - Stéphane Moreau
- Service d'Hématologie Clinique et Thérapie Cellulaire, CHU de Limoges, Limoges, France
| | | | - Sophie Lefort
- Service d'Oncologie et Radiothérapie, Centre Hospitalier, Brive-la-Gaillarde, France
| | | | | | | | - Annick Daulange
- Pharmacie Centrale, Centre Hospitalier, Brive-la-Gaillarde, France
| | - Arnaud Jaccard
- Service d'Hématologie Clinique et Thérapie Cellulaire, CHU de Limoges, Limoges, France
| | - Alain Vergnenègre
- Service d'Information Médicale et d'Evaluation (SIME), CHU de Limoges, Limoges, France
| | - Dominique Bordessoule
- Service d'Hématologie Clinique et Thérapie Cellulaire, CHU de Limoges, Limoges, France
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Corbett M, Heirs M, Rose M, Smith A, Stirk L, Richardson G, Stark D, Swinson D, Craig D, Eastwood A. The delivery of chemotherapy at home: an evidence synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundRecent policy and guidance has focused on chemotherapy services being offered closer to home, but the clinical and economic implications of this are uncertain.ObjectivesTo compare the impact of delivering intravenous chemotherapy in different settings on a range of outcomes, including quality of life, safety and costs.DesignMultimethods approach: systematic review of clinical effectiveness, qualitative and cost-effectiveness studies; description of the patient pathway and brief survey of current provision; and development of a decision model to explore aspects of cost-effectiveness.SettingProvision of intravenous chemotherapy.ParticipantsChemotherapy patients.InterventionsSetting in which chemotherapy was administered (home, community or outpatient).Outcome measuresSafety, quality of life, preference, satisfaction, opinions/experiences, social functioning, clinical outcomes, costs and resource/organisational issues.Data sourcesSixteen electronic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched from inception to October 2013 for published and unpublished studies.Review methodsTwo reviewers independently screened potentially relevant studies, extracted data and quality assessed the included studies. Study validity was evaluated using appropriate quality assessment tools. Clinical effectiveness and cost-effectiveness studies were summarised narratively, and qualitative studies were synthesised using meta-ethnography.ResultsOf the 67 eligible studies, 25 were comparative, with nine including a concurrent economic evaluation. Although some of the 10 randomised trials were designed to minimise avoidable biases, slow recruitment rates and non-participation of eligible patients for setting-related reasons meant that trial sample sizes were small and populations were inherently biased to favour the home or community settings. There was little evidence to suggest differences between settings in terms of quality of life, clinical outcomes, psychological outcomes or adverse events. All nine economic evaluations were judged as having low or uncertain quality, providing limited evidence to draw overall conclusions. Most were cost–consequence analyses, presenting cost outcomes alongside trial results but deriving no summary measure of benefit. Poor resource use reporting and use of different perspectives across settings made results difficult to compare. Seventeen qualitative studies (450 participants) were judged as moderate to good quality, although all compared new or proposed services with existing outpatient facilities and biased samples were used. The three main lines of argument were barriers to service provision, satisfaction with chemotherapy and making compromises to maintain normality. Most patients made explicit trade-offs between the time and energy required for outpatient chemotherapy, which reduced quality of life, and an increased sense of safety. A patient pathway was described, informed by expert advice and a brief survey of NHS and private providers, which identified wide variation in the ways in which home and community chemotherapy was delivered. Considering limitations of the available data and variation in provision, cost-effectiveness modelling results were not robust and were viewed as exploratory only; the results were highly unstable.ConclusionsPrimary studies comparing settings for administering intravenous chemotherapy appear difficult to conduct. Consequently, few robust conclusions can be made about the clinical effectiveness and cost-effectiveness. Qualitative studies indicate that the patient time and energy required for outpatient chemotherapy reduces quality of life. A nested randomised controlled trial within a larger observational cohort of patients is proposed to enhance recruitment and improve generalisability of results. Future economic evaluations require detailed patient characteristic, resource use, cost and quality-of-life data, although their results are likely to have limited generalisability.Study registrationThis study is registered as PROSPERO CRD42013004851.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Mark Corbett
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Morag Heirs
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Micah Rose
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alison Smith
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Lisa Stirk
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Daniel Stark
- Leeds Institute of Cancer & Pathology, University of Leeds, Leeds, UK
| | - Daniel Swinson
- St James’s Institute of Oncology, Leeds Teaching Hospitals Foundation NHS Trust, Leeds, UK
| | - Dawn Craig
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alison Eastwood
- Centre for Reviews and Dissemination, University of York, York, UK
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Economic comparison between Hospital at Home and traditional hospitalization using a simulation‐based approach. JOURNAL OF ENTERPRISE INFORMATION MANAGEMENT 2013. [DOI: 10.1108/17410391311289596] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Stability of antineoplastic agents in use for home-based intravenous chemotherapy. ACTA ACUST UNITED AC 2008; 31:1-13. [DOI: 10.1007/s11096-008-9270-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 11/16/2008] [Indexed: 11/26/2022]
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Cours de cancérologie thoracique du GOLF… ou comment tout apprendre ou presque en oncologie thoracique. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)78127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Meurice J, Roche N. « La Revue des Maladies Respiratoires : l’aventure continue ». Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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