Title : Exploration of home-based chemotherapy patterns in patients with multiple myeloma
Abstract:
Objective: To explore the feasibility, patient cost-effectiveness and potential risks of developing a family treatment model for bortezomib for multiple myeloma in China.
Background: Bortezomib has been widely used in the treatment of plasma cell diseases such as multiple myeloma, light chain amyloidosis, and POEMS syndrome. However, bortezomib could take about six hours of blood tests and other tests, so bortezomib was proposed for the first time. Home-based chemotherapy can improve patient experience, avoid unnecessary hospitalization, improve patient satisfaction, and reduce the cost of patients and their families. However, the current home chemotherapy at home and abroad is mainly oral targeted drugs, and there is no home subcutaneous injection chemotherapy.
Methods: From February 2020 to October 2021, A total of 122 eligible patients with multiple myeloma agreed to participate in the study, And were assigned to the intervention group, the home chemotherapy group (n=60) and the control group (n=62), Patients in the home-based chemotherapy group were evaluated by rigorous screening, Including the Frailty physical fitness assessment, Theoretical and operational training assessment is based on Ke's model, Bortezomib can be injected at home only after passing the assessment, During the process of staying at home, Use the "Home" WeChat group to manage patients' needs and symptoms,, Count the number of adverse events of home-based chemotherapy, Drug-related adverse reactions, To evaluate the efficacy and feasibility of home-based chemotherapy. In the control group, bortezomib was injected by a nurse, and a questionnaire was used to compare the differences in health status, overall well-being, satisfaction, and cost-effectiveness.
Results: In the course of home chemotherapy, the most common adverse reactions were diarrhea (18.9%) and constipation (30%), which could relieve themselves; 1 case of intestinal obstruction, and the team doctor guided the local hospital; 1 case of abnormal liver function, 3 courses of bortezomib after liver protection, and then changed to oral chemotherapy; 3 cases of herpes, which improved after treatment. Bortezomib injection related adverse event occurred once, for one patient after the drug fell to the ground. The experimental group was higher than the control group in terms of health status, overall well-being and satisfaction (p <0.05).among, In terms of the health status, Self-care improvement in home-based chemotherapy patients (p <0.05), emotionally, Happy self-identification, Peace of mind, Feel that life is full, Significant improvement in sensory health, p <0.05; In terms of overall well-being, Such as the pressure feeling, Depression, anxiety, and depression states were significantly better than the control patients (p <0.05), More overall emotional stability; In terms of the satisfaction, Patients in the home treatment group were more satisfied with the care information than the control group (p <0.05), Patients with home-based chemotherapy averaged 19,824 yuan per person, Compared with the 41,170 yuan for hospitalized patients, The average savings is 21,346 yuan per person.
Conclusion: The home chemotherapy model for multiple myeloma patients led by bortezomib is safe and feasible, which can reduce patient costs and improve satisfaction and happiness, and can be actively promoted in other centers in China.
Audience Take Away Notes
- The home chemotherapy model for multiple myeloma patients led by bortezomib is safe and feasible
- Home chemotherapy model for multiple myeloma patients can reduce patient costs and improve satisfaction and happiness, and can be actively promoted in other centers in China.
