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Home-based zoledronic acid infusion therapy in patients with solid tumours: compliance and patient-nurse satisfaction.
MedLine Citation:
PMID:  23299561     Owner:  NLM     Status:  Publisher    
PURPOSE: This study aimed to explore patient and nurse satisfaction, compliance with best practice, technical feasibility and safety of home infusion of the bisphosphonate zoledronic acid (ZOL). METHODS: This was a prospective 1-year survey of home ZOL therapy (4 mg Zometa®, 15-min i.v., every 3-4 weeks) in patients with bone metastases secondary to a solid malignancy. A physician questionnaire, nurse satisfaction/feasibility questionnaire and patient satisfaction questionnaire were administered at several time-points. RESULTS: Physician participation rate was 56.5 % (87/154). Physicians enrolled 818 patients visited by 381 predominantly community nurses. Of the 788 case report forms received, 763 met inclusion criteria. Patient characteristics were as follows: median age, 68 years (30-95); M/F, 40/60; ECOG-PS 0 or 1, 78.6 %;and primary tumour site, breast (55.2 %), prostate (28.4 %), lung (7.2 %) or other (9.4 %). Nurse satisfaction rates were high: organisation of home ZOL therapy, 90.9 %; ease of infusion, 96.7 %; patient-nurse relationship, 97.5 %; and relationship with hospital staff, 73 %. Patient satisfaction was also very high (95.3 %). The main reasons were quality of the nurse-patient relationship (57.6 %), less travel/waiting (68.8 %), home environment (52.9 %) and less disruption to daily routine (36.6 %). ZOL therapy was well tolerated, the discontinuation rate due to adverse events (including deaths whether related to diseases progression or not) was 33.6 %. The incidence of osteonecrosis of the jaw was 0.6 % and of fractures, 0.2 %. Practitioner compliance with best practice was 76.7-83.7 % for recommended and/or tolerated dosage, 73 % for dental hygiene checks at inclusion and 48-56 % thereafter, 66 % for pre-infusion hydration, and often undocumented for calcium/vitamin D supplementation. CONCLUSIONS: Home ZOL therapy was well tolerated. Both patient and nurse satisfaction were very high. However, better compliance with best practice should be encouraged.
Thierry Lebret; Jean-Loup Mouysset; Alain Lortholary; Claude El Kouri; Laurent Bastit; Meryem Ktiouet; Khemaies Slimane; Xavier Murraciole; Stéphane Guérif
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-9
Journal Detail:
Title:  Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer     Volume:  -     ISSN:  1433-7339     ISO Abbreviation:  Support Care Cancer     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9302957     Medline TA:  Support Care Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Hôpital Foch/Urology Department, Université Versailles St Quentin en Yvelines, 40 rue Worth BP 36, 92151, Suresnes Cedex, France,
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