2019•Journal of Clinical OncologyRequires access
Evaluation of quality of life, satisfaction and cost of care in metastatic colorectal cancer patients receiving ambulatory chemotherapy.
Phichai Chansriwong, Suwannee Sirilerttrakul, Nopakan Wannakansophon, Patamaporn Tangteerakoon, Suluck Vongterapak, Manmana Jirajarus, Sineenuch Ckumdee, Ekaphop Sirachainan
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Abstract
6536 Background: Colorectal cancer is an important health problems in Thailand; chemotherapy remains the most suitable treatment for metastatic patients. Chemotherapy treatment that was once delivered only in hospital environments is now administered at patient's home that helping patients to live normal lives during receiving chemotherapy. The chemotherapy regimens are based on a 48 hours 5-fluorouracil infusion combined that need patients to be hospitalized, consequence to decrease QOL and increase cost of treatment. Aims: Compares the QOL score, patients’ satisfaction and cost difference in treating ambulatory chemotherapy (AC) patients compared with inpatient treatment. Methods: An observational cohort which enrolled 156 patients at the Ramathibodi hospital from Dec 2015 to Nov 2016. AC administered by the central venous access device (CVAD). The regimen as FOLFOX or FOLFIRI, 5-FU were in the elastomeric infusion pump and administered at the patients’ home. Nurse coordinators followed up with the patients by phone. The FACT-G and FACT-C scale, patients’ satisfaction and cost of treatment questionnaire were collected at time of enrolment, 2 months and end of treatment. Results: 156 patients are enrolled that 111 patients treated with AC and 45 patients treated with inpatient. 134 returned the questionnaire (response rate 86%). Intention to treat analysis revealed significantly improved in social wellbeing and FACT-G (p <0.001) in AC group. Significant higher administration, service and overall satisfaction score in AC group. The AC reduced cost about 483 US dollars per cycle of chemotherapy. Conclusions: Ambulatory chemotherapy helps colorectal cancer patients to live normal lives by administer treatment at patients' home and results to significantly improve in quality of life especially in social wellbeing and more satisfaction. Moreover, ambulatory chemotherapy reduced cost of chemotherapy treatment.