• Title/Summary/Keyword: outpatient chemotherapy administration

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The Economic Evaluation of Outpatient-chemotherapy administration model (외래 항암 화학요법 주사실 모델의 적정성 분석)

  • Song, Jung Hup
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.16-30
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    • 2004
  • Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

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Survey on the Side Effects of the Vesicant Chemotherapy (정맥으로 투여하는 발포성 항암제의 합병증)

  • Choi Eun-Sook;Kim Keum-Soon;Joo Myung-Soon;Kim Bok-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.3
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    • pp.415-428
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    • 2000
  • The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands(64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous Problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3% Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache(5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p< .05). Day of chemotherapy related to side effects were nausea & vomiting(p< .05). Site of chemotherapy related to side effects were redness(p< .05). Frequency of venipuncture related to side effects were redness(p< .05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.

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Safety Management Status among Nurses Handling Anticancer Drugs: Nurse Awareness and Performance Following Safety Regulations

  • Jeong, Kyeong Weon;Lee, Bo-Young;Kwon, Myung Soon;Jang, Ji-Hye
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3203-3211
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    • 2015
  • This study identified the actual conditions for safe anticancer drug management among nurses and the relationship between level of awareness and performance of anticancer drug safety regulations in terms of preparation, administration, and disposal. The respondents were 236 nurses working with chemotherapy in wards and outpatient clinics in five hospitals in and near Seoul. Safety regulations provided for the anticancer drug the Occupational Safety Health Administration (OSHA, 1999), as modified for an earlier study, were used. The results showed that the level of awareness and performance on the anticancer drug safety regulations indicate their preparation ($3.38{\pm}0.55$, $2.38{\pm}0.98$), administration ($3.52{\pm}0.46$, $3.17{\pm}0.70$), general handling and disposal ($3.33{\pm}0.54$, $2.42{\pm}0.90$) on a scale 0 to 5. Also, there were significant differences in job positions, work experience, type of preparation, and continuing education and a positive relationship between the level of awareness and nursing performance. Thus, nurses should receive continuing education on the handling of anticancer drugs to improve the level of performance following safety regulations.

A Case of Advanced Gastric Cancer with Multiple Leptomeningeal Metastasis (진행성 위암의 추적 관찰 도중 다발성 수막내 전이가 발견된 환자 1례)

  • Hae Jin Shin;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.122-126
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    • 2016
  • Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

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The Value of Tumor Treating Fields in Glioblastoma

  • Zhang, Chaochao;Du, Jianyang;Xu, Weidong;Huang, Haiyan;Gao, Li
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.681-688
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    • 2020
  • Glioblastoma (GBM) is one of the most common tumors of the central nervous system, which is the most lethal brain cancer. GBM treatment is based primarily on surgical resection, combined with radiotherapy and chemotherapy. Despite the positive treatment, progression free survival and overall survival were not significantly prolonged because GBM almost always recurs. We are always looking forward to some new and effective treatments. In recent years, a novel treatment method called tumor treating fields (TTFields) for cancer treatment has been proposed. TTFields devices were approved by the Food and Drug Administration (FDA) for adjuvant treatment of recurrent and newly diagnosed GBMs in 2011 and 2015, respectively. This became the first breakthrough treatment for GBM in the past 10 years after the FDA approved bevacizumab for patients with relapsed GBM in 2009. This paper summarized the research results of TTFields in recent years and elaborated the mechanism of action of TTFields on GBM, including cell and animal experimental research, clinical application and social benefits.

The Development of Multidisciplinary Cancer Patient Education·Counseling Questionnaire and Satisfaction Survey (다직종 암환자 교육·상담에 대한 설문 개발과 환자 만족도 조사)

  • Lee, Min Jeong;Geum, Min Jung;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun;Lee, Sang Geul;Song, Su Kyung;Choi, Hye Jin
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.138-145
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    • 2018
  • Background: Presently, a multidisciplinary team of doctors, pharmacists, nurses, and dietitians provides patient education to impart information on chemotherapy. However, studies on multidisciplinary education satisfaction are inadequate. In this study, we aimed to contribute to the improvement of quality of multidisciplinary education counseling for patients with cancer by developing a satisfaction questionnaire and analyzing the satisfaction survey. Methods: A questionnaire was developed by an expert group, and the responses were recorded using the 5-point Likert scale. After conducting a pre-test, factor analysis was performed to evaluate validity. The reliability of the questionnaire was measured by Cronbach's alpha coefficient. A satisfaction survey was conducted by self-administration method. Results: Based on the results of factor analysis, factors can be divided into two parts: "overall education" and "each team member's education" (total 14 questions). The construct validity and reliability of the questionnaire are sufficiently high. Fifty-one patients took the survey between January 2, 2018 and January 20, 2018. Twenty-six (51%) patients responded that they were "very satisfied" and 22 (43.1%) patients responded that they were "satisfied". Conclusion: By developing a questionnaire on multidisciplinary education counseling for patients with cancer, it is possible to perform evaluation and research of cancer patient education. This study will contribute to the management and improvement of quality of multidisciplinary education.