1584P - Home-based zoledronic acid (ZOL) infusion therapy in patients with solid tumours: compliance and patient-nurse satisfaction

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive Care
Presenter Thierry Lebret
Authors T. Lebret1, J. Mouysset2, A. Lortholary3, C. El Kouri3, L. Bastit4, M. Ktiouet5, K. Slimane5, X. Muracciole6, S. Guérif7
  • 1Urology, Hôpital Foch, 92150 - Suresnes/FR
  • 2Oncology, Polyclinique Parc Rambot-Provençale, 13100 - AIX EN PROVENCE/FR
  • 3Medical Oncology, Catherine de Sienne Institute, 44202 - Nantes/FR
  • 4Radiothérapie, centre de radiothérapie, 27000 - EVREUX/FR
  • 5Oncology, Novartis Pharmaceuticals, 92500 - Rueil-Malmaison/FR
  • 6Service De Radiotherapie, CHU La Timone APHM Marseille, 13385 - Marseille/FR
  • 7Radiothérapie, CHU Poitiers, 86021 - Poitiers/FR

Abstract

Objective

To explore patient and nurse satisfaction, compliance with practice guidelines, technical feasibility, and safety of home infusion of the bisphosphonate ZOL.

Methods

This was a prospective longitudinal 1-year survey of home ZOL therapy in patients with bone metastases secondary to a solid malignancy. Randomly selected physicians prescribed home ZOL therapy (4 mg Zometa®, 15-min IV infusion, every 3-4 weeks). Three questionnaires were administered at 3 time points: physician questionnaire, nurse satisfaction and feasibility questionnaire, and patient satisfaction questionnaire. The main end-points were patient and nurse satisfaction with home ZOL therapy.

Results

Of the 154 physicians who agreed to participate, 87 (56.5%) enrolled 818 patients for whom 788 case report forms were received of which 763 met inclusion criteria. Overall, 343 nurses (97.5% community) took part. Patient characteristics were: median age 68 yrs (30-95); male-female ratio 40/60; primary cancer: breast 55.2%, prostate 28.4%, lung 7.2%, other 9.4%; ECOG-PS 0 or 1: 78.6%. Overall, 90.9% of nurses were either highly satisfied or satisfied with how home ZOL therapy was run; 96.7% found the infusion either very easy or easy to perform; 97.5% felt that home therapy promoted a good relationship with patients, and 73% were either highly satisfied or satisfied with their hospital contacts. Among patients, 95.3% were either very satisfied or satisfied with home ZOL therapy. Causes for satisfaction were quality of the nurse-patient relationship (57.6%) in addition to expected reasons (e.g. less time travelling/waiting (68.8%), less disruption to daily routine (36.6%)). ZOL therapy was well tolerated (discontinuation due to adverse events 6.1%; osteonecrosis of the jaw 0.6%, fractures 0.2%). Practitioner compliance with recommendations was 73% for dental hygiene checks at inclusion and 48-56% thereafter, 66% for pre-infusion patient hydration, and often undocumented for calcium/vitamin D supplementation.

Conclusions

There was a very high level of both patient and nurse satisfaction with home ZOL therapy. However, improved compliance with practice guidelines should be encouraged.

Disclosure

T. Lebret: Consulting fees : Amgen, Novartis Advisory board : Amgen, Novartis Honorarium study Novartis,

J. Mouysset: Honorarium study Novartis,

A. Lortholary: Honorarium study Novartis,

C. El Kouri: Honorarium study Novartis,

L. Bastit: Honorarium study Novartis

M. Ktiouet: Novartis Employee

K. Slimane: Novartis Employee,

X. Muracciole: Advisory board Novartis Consulting fees Novartis,

S. Guérif: Consulting fees Novartis.