Article
Subjective and Substantiated Quality of Life Under In-Hospital Versus Ambulatory Chemotherapy in an Oncologic Day Care Center
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Published: | March 20, 2006 |
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Background: Infrastructural changes within our department also affected our Oncologic Day Care Center. Since November 2004, most chemotherapy treatments are administered at the Day Care Center. The Center underwent environmental upgrades and was reorganized in order to clearly distinguish ambulatory from in-hospital care (same staff, brightly decorated rooms, pleasant environment with music, aromatherapy lamps, fruit baskets, tea, optional massages). The Day Care Center staff gained the impression that patients appeared to tolerate ambulatory chemotherapy better than in-hospital chemotherapy; an impression confirmed in conversations with patients, who agreed that their quality of life seemed definitely improved.
Methods: We aimed to assess if subjective quality of life improvements can be quantitated with the respective WHO chemotherapy toxicity questionnaires. For this purpose, we retrospectively compared therapy cycles administered in the hospital with respective cycles administered on an ambulatory basis (mean value + standard deviation, Student’s t-test).
Results: An advantage of ambulatory chemotherapy could only be demonstrated for FEC chemotherapy and fatigue syndrome (p= 0.04). For all other types of therapy, ambulatory management did not reveal advantages with respect to the occurrence of nausea/vomiting. In-hospital administration of Carboplatin / Paclitaxel was in fact superior with respect to fatigue syndrome (p= 0.008).
Conclusions: Patients associate ambulatory chemotherapy with enhanced quality of life. Our results indicate that toxicity questionnaires are inadequate or make such superiority difficult to establish. We are planning a prospective study to evaluate how ambulatory chemotherapy in an Oncologic Day Care Center impacts quality of life.