Health-related quality of life anticipated with different management strategies for febrile neutropenia in adult cancer patients

Teuffel, Oliver; Cheng, Sylvia; Ethier, Marie‐Chantal; Diorio, Caroline; Martino, Julia; Mayo, C.; Wing, Richard E.; Sung, Lillian; Alibhai, Shabbir M.H.

doi:10.1007/s00520-012-1397-8

Cited by 24 publications

(23 citation statements)

References 34 publications

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“…In particular, 36% preferred an outpatient management with oral antibiotics, 21% an outpatient management with intravenous antibiotics, and 18% an oral treatment at home after an initial observation in the hospital [37]. …”

Section: Discussionmentioning

confidence: 99%

“…Identification of patients suitable for outpatient management is crucial since this cost-effective strategy allows savings, limits the risk of hospital-acquired infections and improves the patients' quality of life [36,37]. FN patients with a MASCC score ≥ 21 and without other clinical warning signs can be safely managed in the outpatient setting if they are able to take oral medication and have a committed caregiver [38,39].…”

Section: Management Of Febrile Neutropeniamentioning

confidence: 99%

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Management of Breast Cancer Patients with Chemotherapy-Induced Neutropenia or Febrile Neutropenia

et al. 2014

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Chemotherapy-induced neutropenia (CIN) is a common toxicity caused by the administration of anticancer drugs. This side effect is associated with life-threatening infections and may alter the chemotherapy schedule, thus impacting on early and long-term outcomes. Elderly breast cancer patients with impaired health status or advanced disease as well as patients undergoing dose-dense anthracycline/taxane- or docetaxel-based regimens have the highest risk of CIN. A careful assessment of the baseline risk for CIN allows the selection of patients who need primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) and/or antimicrobial agents. Neutropenic cancer patients may develop febrile neutropenia and CIN-related severe medical complications. Specific risk assessment scores, along with comprehensive clinical evaluation, are able to define a group of febrile patients with low risk for complications who can be safely treated as outpatients. Conversely, patients with higher risk of severe complications should be hospitalized and should receive intravenous antibiotic therapy with or without G-CSF.

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Section: Discussionmentioning

confidence: 99%

Section: Management Of Febrile Neutropeniamentioning

confidence: 99%

Management of Breast Cancer Patients with Chemotherapy-Induced Neutropenia or Febrile Neutropenia

et al. 2014

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“…56 Of the remaining studies that considered acceptability in OPAT patients only, most involved multiple OPAT models (and did not differentiate between them in their findings), or did not specify the model(s) under study. In general, satisfaction with treatment was very high, 2,13,27,36,[67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83] including when patients had to have frequent attendance at hospital. 5,84 Commonly perceived advantages of OPAT included the ability to resume daily activities, 2,27,71,73 feelings of improved self-esteem or greater freedom and control, 67,71,73,85,86 and not having to remain in or attend hospital.…”

Section: Patient Acceptabilitymentioning

confidence: 99%

“…5,12,13,15,25,27,36,41,67,68,70,73,[75][76][77][78][80][81][82]86,89 Only six interview-based studies were identified by the review. 35,37,79,85,88,99 The literature indicates that patients generally view OPAT very positively. The main benefits relate to the comfort of the home environment 56,85,86,99 and increased freedom and autonomy.…”

Section: Contextmentioning

confidence: 99%

The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy

Minton

Czoski-Murray

Meads

et al. 2017

Health Serv Deliv Res

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“…Although most patients with a single axillary body temperature of ≥38˚C occurring between days 8 and 14 after the start of chemotherapy may have neutropenia and may be diagnosed with FN (10), outpatient management without initial assessment for these patients is routinely performed at our hospital. Implementation of this type of outpatient management can avoid unnecessary consultations, decrease costs, limit the risk of hospital-acquired infections and improve patients' quality of life (11)(12)(13), although it can also lead to insufficient initial assessment and inappropriate initial therapy. The JSMO guidelines do not recommend this type of outpatient management without initial assessment for febrile patients, although they also state that these recommendations may be modified, depending on the characteristics of individual malignancies and organs (5).…”

Section: Introductionmentioning

confidence: 99%

Outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer

Kimura

Tanaka

Iwamoto

et al. 2016

Molecular and Clinical Oncology

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Abstract. The purpose of this study was to retrospectively analyze the feasibility of outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer. A total of 131 consecutive patients with breast cancer treated with adjuvant or neoadjuvant chemotherapy from 2011 to 2013 at Osaka Medical College Hospital (Osaka, Japan) were retrospectively reviewed. In the case of developing a fever (body temperature, ≥38˚C), the outpatients had been instructed to take previously prescribed oral antibiotics for 3 days without any initial assessment, and if no improvement had occurred by then, they were required to visit the hospital for examination and to undergo treatment based on the results of a risk assessment for complications. The primary aim of the present study was to assess the outcome of febrile episodes, while the secondary aim was to assess the incidence of febrile episodes, hospitalizations, and the type of chemotherapy. The 131 patients received 840 chemotherapy administrations. Fifty-five patients (42.0%) had a total of 75 febrile episodes after 840 chemotherapy administrations (8.9%). Treatment failure occurred in 12 of the 75 episodes (16.0%) in 11 of the 55 patients (20.0%). Only four episodes required hospitalization. Treatment success was achieved in 63 episodes (84.0%). In conclusion, the feasibility of outpatient management without initial assessment was evaluated in the present study for febrile patients undergoing adjuvant chemotherapy for breast cancer, and the outpatient strategy regimen may be safe and convenient for these patients.

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Health-related quality of life anticipated with different management strategies for febrile neutropenia in adult cancer patients

Abstract: Our study indicates that the majority of adult cancer patients would prefer an outpatient strategy for FN. However, patients' preferences vary substantially at the individual level. Implementation of outpatient strategies into routine clinical practice should consider this variability.

Cited by 24 publications

References 34 publications

Management of Breast Cancer Patients with Chemotherapy-Induced Neutropenia or Febrile Neutropenia

Management of Breast Cancer Patients with Chemotherapy-Induced Neutropenia or Febrile Neutropenia

The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy

Outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer

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