Key issues of patient safety during anticancer drug treatment in a day hospital and outpatient setting

Background. In the context of the ongoing COVID-19 pandemic, the vector of healthcare development is aimed at minimizing contacts among citizens, which is especially important for cancer patients, given the immunosuppression caused by cytostatics.The objective of the review is to present the development prospects of hospital-substituting technologies for drug antitumor treatment. Two main components are considered that allow effective and safe infusion of anticancer drugs in a day hospital: central venous access devices and infusion pumps, various types of these devices, their safety and experience of use today are described.Materials and methods. We searched for available literature published in PubMed, Medline, eLIBRARY, Cochrane Library, CyberLeninka, Global.health, etc. 42 sources were found and analyzed, published from 2002 to 2021.Results. Outpatient anticancer drug treatment is a real alternative to hospital stay, based on many years of world experience. The qualifications level of medical personnel involved in the treatment process should allow early monitoring of various adverse events development. With the ongoing COVID-19 pandemic, it is important to ensure the continuity of the treatment process while minimizing risks to the patient.Conclusion. With a careful approach and adequate infrastructure availability, drug treatment in a day hospital can reduce the burden on round-the-clock stay hospital and positively affect the patients’ quality of life and their compliance with treatment.

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Central Venous Access by Air Medical Personnel

Prehospital Emergency Care ◽

10.1080/10903120701205232 ◽

2007 ◽

Vol 11 (2) ◽

pp. 204-206 ◽

Cited By ~ 7

Author(s):

Daniel P. Davis ◽

Prasanthi Ramanujam

Keyword(s):

Central Venous Access ◽

Medical Personnel ◽

Venous Access ◽

Central Venous

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Central venous access port devices (cvapds) for cancer patients placed by medical oncologist at the oncology day hospital (odh). A prospective study

Journal of Clinical Oncology ◽

10.1200/jco.2004.22.14_suppl.8247 ◽

2004 ◽

Vol 22 (14_suppl) ◽

pp. 8247-8247

Author(s):

J. M. Campos ◽

O. Juan Vidal ◽

A. Albert ◽

V. Caranyana ◽

I. Rico ◽

...

Keyword(s):

Prospective Study ◽

Cancer Patients ◽

Central Venous Access ◽

Venous Access ◽

Day Hospital ◽

Central Venous ◽

Medical Oncologist ◽

Access Port ◽

Venous Access Port ◽

A Prospective Study

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Palliative ambulatory 14-day infusional ifosfamide in the outpatient setting for treatment of advanced soft tissue sarcomas (STS): “Old wine in a new bottle.”

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.10039 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 10039-10039

Author(s):

Salma Moona Alam ◽

Charlotte Benson ◽

David Olmos ◽

Robin Lewis Jones ◽

Scott Mitchell ◽

...

Keyword(s):

Soft Tissue ◽

Synovial Sarcoma ◽

Central Venous Access ◽

Soft Tissue Sarcomas ◽

Venous Access ◽

Median Number ◽

Outpatient Setting ◽

Response To Treatment ◽

Best Response ◽

Number Of Cycles

10039 Background: Ifosfamide (IFO) has recognised activity in soft tissue sarcomas. There is evidence for improved cytotoxicity and tolerability utilising a prolonged 14 day infusional outpatient regimen compared with the standard 3-day regimen (Loeffler et al 1990). We undertook a retrospective review of all patients treated with this regimen from September 2008 - December 2011 to determine toxicity and treatment response. Methods: Pts. were identified from our database and demographics, histological subtype, toxicity and survival outcomes were collected. IFO was given via central venous access using 2 x 7 day pumps at 1g/m2/day with mesna for 14 days q 4 weekly. Oral sodium bicarbonate was used to maintain alkaline urine with oral mesna for haematuria, and thiamine for symptoms of encephalopathy as required. Results: 29 patients (pts), with advanced sarcoma, median age 56 years (27-76 yrs), 14F 15 M, median number of cycles = 1 ( 1-9). At baseline: PS 0=1, 1=24, 2=4. 18 pts had de-differentiated liposarcoma (D-LPS), 6 synovial sarcoma, 5 had other subtypes. 12 pts received only 1 cycle, with 5 stopping due to encephalopathy. Ten patients developed encephalopathy, 9 occurring in cycle 1, other toxicity was tolerable, with Gr 2-3 nausea (15 pts) and vomiting (9pts) and only 2 Gr 3 episodes of myelotoxicity for all cycles. 4 patients achieved PR, (2 with D-LPS and 2 with Synovial sarcoma) 11 pts. had SD. Median PFS was 19 months and OS was 12.5 months. 2 pts. with D-LPS had a sustained prolonged response of 15 and 16 months. Conclusions: Infusional IFO is generally well tolerated; however a significant incidence of neurotoxicity was seen. Pts. with D-LPS demonstrated best response to treatment, a sarcoma subtype that has previously failed to respond to systemic therapy. This regime warrants further investigation.

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A Nurse-led Central Venous Vascular Access Service in the United kingdom

Journal of the Association for Vascular Access ◽

10.2309/1552-8855-10.2.77 ◽

2005 ◽

Vol 10 (2) ◽

pp. 77-80

Author(s):

Helen C. Hamilton

Keyword(s):

Central Venous Access ◽

Medical Personnel ◽

Venous Access ◽

General Anesthetic ◽

Central Venous ◽

The United Kingdom ◽

Access Service ◽

Improving Patient Care ◽

Venous Access Devices

Abstract The insertion of central venous access devices for patients requiring all forms of central venous therapy is expensive and time consuming, particularly if general anesthetic and operating facilities are used by medical personnel, By expanding the role of a nurse who specialized in parenteral nutrition and who had previous experience in critical care, this procedure was able to be Performed Percutaneously at the bedside, cutting costs, freeing medical staff time, and improving patient care.

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