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dc.contributor.authorMolassiotis, Alexanderen
dc.contributor.authorBrearley, Sarahen
dc.contributor.authorSaunders, Mark Pen
dc.contributor.authorCraven, Oliveen
dc.contributor.authorWardley, Andrew Men
dc.contributor.authorFarrell, Caroleen
dc.contributor.authorSwindell, Ricen
dc.contributor.authorTodd, Chrisen
dc.contributor.authorLuker, Karenen
dc.date.accessioned2010-02-09T10:57:46Z
dc.date.available2010-02-09T10:57:46Z
dc.date.issued2009-12-20
dc.identifier.citationEffectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy: a randomized, controlled trial. 2009, 27 (36):6191-8 J. Clin. Oncol.en
dc.identifier.issn1527-7755
dc.identifier.pmid19917849
dc.identifier.doi10.1200/JCO.2008.20.6755
dc.identifier.urihttp://hdl.handle.net/10541/91475
dc.description.abstractPURPOSE: To assess the effectiveness of a symptom-focused home care program in patients with cancer who were receiving oral chemotherapy in relation to toxicity levels, anxiety, depression, quality of life, and service utilization. PATIENTS AND METHODS: A randomized, controlled trial was carried out with 164 patients with a diagnosis of colorectal (n = 110) and breast (n = 54) cancers who were receiving oral capecitabine. Patients were randomly assigned to receive either a home care program by a nurse or standard care for 18 weeks (ie, six cycles of chemotherapy). Toxicity assessments were carried out weekly for the duration of the patients' participation in the trial, and validated self-report tools assessed anxiety, depression, and quality of life. RESULTS: Significant improvements were observed in the home care group in relation to the symptoms of oral mucositis, diarrhea, constipation, nausea, pain, fatigue (first four cycles), and insomnia (all P < .05). This improvement was most significant during the initial two cycles. Unplanned service utilization, particularly the number of inpatient days (57 v 167 days; P = .02), also was lower in the home care group. CONCLUSION: A symptom-focused home care program was able to assist patients to manage their treatment adverse effects more effectively than standard care. It is imperative that patients receiving oral chemotherapy are supported with such programs, particularly during initial treatment cycles, to improve their treatment and symptom experiences.
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectColorectal Canceren
dc.subject.meshAdministration, Oral
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshAntimetabolites, Antineoplastic
dc.subject.meshBreast Neoplasms
dc.subject.meshCase-Control Studies
dc.subject.meshColorectal Neoplasms
dc.subject.meshDeoxycytidine
dc.subject.meshFemale
dc.subject.meshFluorouracil
dc.subject.meshHome Care Services
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPalliative Care
dc.subject.meshQuality of Life
dc.titleEffectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy: a randomized, controlled trial.en
dc.typeArticleen
dc.contributor.departmentUniversity of Manchester, School of Nursing, University Place, Manchester, M13 9PL, United Kingdom. alex.molassiotis@manchester.ac.uken
dc.identifier.journalJournal of Clinical Oncologyen
html.description.abstractPURPOSE: To assess the effectiveness of a symptom-focused home care program in patients with cancer who were receiving oral chemotherapy in relation to toxicity levels, anxiety, depression, quality of life, and service utilization. PATIENTS AND METHODS: A randomized, controlled trial was carried out with 164 patients with a diagnosis of colorectal (n = 110) and breast (n = 54) cancers who were receiving oral capecitabine. Patients were randomly assigned to receive either a home care program by a nurse or standard care for 18 weeks (ie, six cycles of chemotherapy). Toxicity assessments were carried out weekly for the duration of the patients' participation in the trial, and validated self-report tools assessed anxiety, depression, and quality of life. RESULTS: Significant improvements were observed in the home care group in relation to the symptoms of oral mucositis, diarrhea, constipation, nausea, pain, fatigue (first four cycles), and insomnia (all P < .05). This improvement was most significant during the initial two cycles. Unplanned service utilization, particularly the number of inpatient days (57 v 167 days; P = .02), also was lower in the home care group. CONCLUSION: A symptom-focused home care program was able to assist patients to manage their treatment adverse effects more effectively than standard care. It is imperative that patients receiving oral chemotherapy are supported with such programs, particularly during initial treatment cycles, to improve their treatment and symptom experiences.


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