Systematic patient involvement for homebased outpatient administration of complex chemotherapy in acute leukemia and lymphoma

Fridthjof, Katrine S.; Kampmann, Peter; Dünweber, Anne; Gørløv, Jette Sønderskov; Nexø, Connie; Friis, Lone Smidstrup; Nørskov, Kristina Holmegaard; Welinder, Pernille; Moser, Claus; Kjeldsen, Lars; Møller, Tom

doi:10.1111/bjh.15249

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…A sub-type of AML is acute promyelocytic leukemia (APL) accounting for around 5-10% of all AML diagnosis [1]. Through the last decade, curative regimens for AL have only improved to a limited extent [1], while supportive care has improved significantly [6][7][8][9]. Specifically, in Northern Europe and the USA, an increasing number of patients are receiving the majority of their treatment in the outpatient setting [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Patient ambassador support in newly diagnosed patients with acute leukemia during treatment: a feasibility study

Nørskov

Overgaard

Boesen

et al. 2020

Support Care Cancer

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Purpose This study investigated the feasibility of patient ambassador support in newly diagnosed patients with acute leukemia during treatment. Methods A multicenter single-arm feasibility study that included patients newly diagnosed with acute leukemia (n = 36) and patient ambassadors previously treated for acute leukemia (n = 25). Prior to the intervention, all patient ambassadors attended a 6-h group training program. In the intervention, patient ambassadors provided 12 weeks of support for patients within 2 weeks of being diagnosed. Outcome measures included feasibility (primary outcome), safety, anxiety, and depression measured by the Hospital Anxiety and Depression Scale, quality of life by the Functional Assessment of Cancer Therapy–Leukemia and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and symptom burden by MD Anderson Symptom Inventory, the Patient Activation Measure, and the General Self-Efficacy Scale. Results Patient ambassador support was feasible and safe in this population. Patients and patient ambassadors reported high satisfaction with the individually adjusted support, and patients improved in psychosocial outcomes over time. Patient ambassadors maintained their psychosocial baseline level, with no adverse events, and used the available support to exchange experiences with other patient ambassadors and to manage challenges. Conclusion The patient ambassador support program is feasible and has the potential to be a new model of care incorporated in the hematology clinical care setting, creating an active partnership between patients and former patients. This may strengthen the existing supportive care services for patients with acute leukemia. Trial registration NCT03493906

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Section: Introductionmentioning

confidence: 99%

Patient ambassador support in newly diagnosed patients with acute leukemia during treatment: a feasibility study

Nørskov

Overgaard

Boesen

et al. 2020

Support Care Cancer

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“…Within healthcare delivery services, including biologically infused treatments for RRMS, there is a trend towards moving complex medical treatments from the hospital environment to a homecare scenario. 41 While this may be a positive development for some patient groups, our study shows that hospital-based infusion treatment provides patients with significant security, knowledge and support in dealing with their MS and would be problematic if lost. A recent study on new models of care for the home-based infusion of DMDs serves as an example of this.…”

Section: Open Accessmentioning

confidence: 75%

Qualitative factors shaping MS patients’ experiences of infusible disease-modifying drugs: a critical incident technique analysis

Larsen¹,

Schäfer

Nielsen

et al. 2020

BMJ Open

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ObjectiveTo explore factors shaping the experiences of patients with relapsing-remitting multiple sclerosis with infusible disease-modifying drugs in a hospital setting.Design and settingsThe critical incident technique served as a framework for collecting and analysing patients’ qualitative account practices involving infusible disease-modifying drugs. Data were collected through semistructured interviews and one single-case study. Participants were recruited from all five regions in Denmark. Inductive thematic analysis was used to identify and interpret factors shaping patients’ infusion journey over time.ParticipantsTwenty-two patients with relapsing-remitting multiple sclerosis receiving infusion with disease-modifying drugs (natalizumab, alemtuzumab and ocrelizumab).ResultsFour time scenarios—preinfusion, day of infusion, long-term infusion and switch of infusion—associated with the infusion of disease-modifying drugs were analysed to reveal how different factors could both positively and negatively affect patient experience. Time taken to make the treatment decision was affected by participants’ subjective perceptions of their disease activity; this may have set off a treatment dilemma in the event of a pressing need for treatment. Planning and routine made infusion practices manageable, but external and internal surroundings, including infusion room ambience and the quality of relationships with healthcare professionals and fellow patients, affected patients’ cognitive state and well-being irrespective of the infusion regimen. Switching the infusion regimen can reactivate worries akin to the preinfusion scenario.ConclusionThis study provides novel insight into the positive and negative factors that shape patients’ experience of infusion care practices. From a patient’s perspective, an infusion practice is not a solitary event in time but includes planning and routine which become an integral part of their multiple sclerosis management. The quality of space and the ambience of the infusion room, combined with the relationship with healthcare professionals and fellow patients, can be a significant source of knowledge and support people with relapsing-remitting multiple sclerosis in their experience of agency in life.

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“…Furthermore, a substantial part of cancer treatment has moved from inpatient to outpatient clinics 20 . The short TAT needed for this type of setup can be achieved by using POC CBC devices, which are also needed in the patients' homes for monitoring at home administrated chemotherapy 21,22 …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, these instruments do not need elaborate priming and calibration/control procedures for startup and require less maintenance 14,27,28 . Therefore, HemoScreen is well suited in an outpatient setting for chemotherapy administration guidance and handling of acute leukemia patients with chemotherapy‐induced pancytopenia 21,22 …”

Section: Discussionmentioning

confidence: 99%

The HemoScreen hematology point‐of‐care device is suitable for rapid evaluation of acute leukemia patients

Kur

Thøgersen

Kjeldsen

et al. 2020

Int J Lab Hematology

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Background Hematological patients, receiving intensive chemotherapy (predominantly acute leukemia patients), have repeated postchemotherapy periods with severe bone marrow suppression. As a result, these patients require regular monitoring of the complete blood counts (CBC) for optimal patient care. To reduce the strain on the patient, there is a need for a point‐of‐care (POC) hematology device that provides rapid and reliable results both in general and in cytopenic samples and is suitable for outpatient clinics. We evaluated the HemoScreen device for the most used CBC parameter both overall and at the lower range. Methods The HemoScreen was compared with the Sysmex XN‐9000 in 206 routine venous samples and 79 capillary bedside samples focusing on white blood cells (WBC), absolute neutrophil count (ANC), red blood cells (RBC), PLT and HGB. Results The HemoScreen was less precise compared to the acceptance criteria set for larger and more advanced hematology instrument with a CV% 3.0‐3.7 for WBCs, 3.6‐8.4 for ANCs, 1.1‐1.5 for RBCs, 2.5‐4.4 for PLTs, and 1.7‐2.3 for HGB. Correlation coefficient for all five parameters for the entire range was r >.95 and r >.90 at lower range for venous and capillary samples. Bias limits were within the CTCAE acceptance limits. Conclusions The HemoScreen provides rapid and accurate test results, for evaluation of WBC, PLT, and HGB, as well as at low concentrations for guiding transfusions and postchemotherapy treatment. The device is easy to operate and can measure both venous and capillary samples. Therefore, the HemoScreen is well suited for smaller outpatient clinics and potentially home use.

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Systematic patient involvement for homebased outpatient administration of complex chemotherapy in acute leukemia and lymphoma

Cited by 16 publications

References 15 publications

Patient ambassador support in newly diagnosed patients with acute leukemia during treatment: a feasibility study

Patient ambassador support in newly diagnosed patients with acute leukemia during treatment: a feasibility study

Qualitative factors shaping MS patients’ experiences of infusible disease-modifying drugs: a critical incident technique analysis

The HemoScreen hematology point‐of‐care device is suitable for rapid evaluation of acute leukemia patients

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