Purpose The on-body injector (OBI) automatically delivers pegfilgrastim the day after chemotherapy (CTx), thus eliminating the need of return visits to the medical office for guideline-compliant pegfilgrastim administration. The CONVENIENCE study aimed to evaluate patient, nurse, and physician preferences as well as health economics for pegfilgrastim administration either with OBI or manually using a pre-filled syringe (PS). Methods Patients with early breast cancer, receiving two or three weekly anthracycline/cyclophosphamide or three weekly taxane-based CTx, and patients with Non-Hodgkin lymphoma (NHL) receiving first-line R-CHOP-14 or -21 were randomized 1:1 to receive both pegfilgrastim application forms for four consecutive CTx cycles in an alternating sequence starting either with OBI or PS. Primary endpoint was patient preference, assessed by questionnaires. Results A total of 308 patients were evaluable in the per-protocol analysis. Patients slightly preferred OBI over PS (OBI, n = 133, 43.2%; vs. PS, n = 111, 36.0%; p-value = 0.159), while study nurses slightly preferred PS (n = 19, 46.3%) over OBI (n = 18, 43.9%) and physicians clearly preferred PS (n = 24, 58.8%) over OBI (n = 15, 36.6%). Among patients with preference for OBI, saving of time was their major reason for preference (53.4%). Pegfilgrastim was administered 24–72 h after each CTx cycle in 97.6% of OBI and 63.1% of PS applications. Conclusion The OBI was slightly preferred by patients and saving time was the major reason for their preference. PS was physicians’ most preferable choice and slightly preferred by nurses. Using OBI, pegfilgrastim was almost always administered within the time period recommended by current guidelines, while it was often not applied as specified using PS. Trial registration No: ClinicalTrials.gov No. NCT03619993. Registered on June 25, 2018
Eine anstehende Geburt und der damit verbundene zeitnahe Transport in die geeignete Entbindungsklinik sind im Rettungsdienst alltägliche Routine. Bei einer bereits einsetzenden Geburt wird aus dem Routineeinsatz rasch ein "komplexes Szenario". Dieser Beitrag gibt Einblicke in den normalen Ablauf einer Spontangeburt; zudem werden ausgewählte Geburtskomplikationen und deren Management betrachtet. Allgemeines Der Mutterpass ist das wichtigste Dokument in der Schwangerschaft. Er enthält neben wichtigen medizinischen Untersuchungsergebnissen wie ▪ errechneter Geburtszeitpunkt, ▪ Schwangerschaftsrisiken, ▪ Erst-oder Mehrgebärende auch unverzichtbare Informationen über spezifische Risiken im Zusammenhang mit der anstehenden Geburt wie z. B. ▪ Plazenta praevia, ▪ Beckenendlage, ▪ Querlage. Deshalb ist der zielgerichtete Blick in den Mutterpass für den eintreffenden Rettungsdienst unverzichtbar! Routineeinsatz im Rettungsdienst, Transport einer Schwangeren am Termin mit beginnender Wehentätigkeit. Als wichtigstes Dokument gilt der Mutterpass.
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