Journal Article

Home-based zoledronic acid infusion therapy in patients with solid tumours: compliance and patientâeuro\nurse satisfaction

Lebret, Thierry, Lortholary, Alain, Bastit, Laurent, Ktiouet, Meryem, Guérif, Stéphane, Slimane, Khemaies, Mouysset, Jean-loup, El Kouri, Claude, Murraciole, Xavier

2013

Overview

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). This was a prospective 1-year survey of home ZOL therapy (4Â mg ZometaÂ, 15-min i.v., every 3â[euro]\"4Â 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. Physician participation rate was 56.5Â % (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, 68Â years (30â[euro]\"95); M/F, 40/60; ECOG-PS 0 or 1, 78.6Â %;and primary tumor site, breast (55.2Â %), prostate (28.4Â %), lung (7.2Â %) or other (9.4Â %). Nurse satisfaction rates were high: organization of home ZOL therapy, 90.9Â %; ease of infusion, 96.7Â %; patientâ[euro]\"nurse relationship, 97.5Â %; and relationship with hospital staff, 73Â %. Patient satisfaction was also very high (95.3Â %). The main reasons were quality of the nurseâ[euro]\"patient relationship (57.6Â %), less travel/waiting (68.8Â %), home environment (52.9Â %) and less disruption to daily routine (36.6Â %). ZOL therapy was well tolerated, the discontinuation rate due to adverse events (including deaths whether related to diseases progression or not) was 33.6Â %. The incidence of osteonecrosis of the jaw was 0.6Â % and of fractures, 0.2Â %. Practitioner compliance with best practice was 76.7â[euro]\"83.7Â % for recommended and/or tolerated dosage, 73Â % for dental hygiene checks at inclusion and 48â[euro]\"56Â % thereafter, 66Â % for pre-infusion hydration, and often undocumented for calcium/vitamin D supplementation. Home ZOL therapy was well tolerated. Both patient and nurse satisfaction were very high. However, better compliance with best practice should be encouraged.[PUBLICATION ABSTRACT]

• Publisher: Springer Nature B.V
• Subject: Acids / Best practice / Bones / Calcium / Community nurses / Compliance / Critical incidents / Deaths / Dietary supplements / Discontinued / Disruption / Dosage / Drug therapy / Feasibility / Fractures / Home based / Home environment / Home health care / Hydration / Medical personnel / Medical treatment / Metastasis / Nurse patient relationships / Nurses / Patient satisfaction / Patients / Personal safety / Physicians / Practitioner patient relationship / Prostate / Questionnaires / Satisfaction / Therapy / Tumors / Vitamins