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December 2011
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Commissioning cancer care: report from the 2011 London Cancer New Drugs Group annual conference
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Chemotherapy in the community
Cheryl Vidall (Clinical Risk and Practice Development Manager, Healthcare at Home) argued the case for considering chemotherapy at home as a safe and viable option in the 21st century. The delivery of chemotherapy in the community has evolved in response to factors such as changing practices, growing pressures on infusion suites, providing safety and patient choice and delivering the Cancer Reform Strategy.7
Ms Vidall explained that although the members of a team delivering infusional chemotherapy are “remote working”, they still function as they would if they were working in a hospital ward. When a chemotherapy prescription is sent to Healthcare at Home, it is verified by an oncology pharmacist; the drug is then compounded and delivered by coldchain to the nurse who collects it and administers the treatment. The service provides national coverage, which is particularly beneficial for patients living in remote locations or for patients who require treatment when they are away from home.
The service also offers benefits to patients taking oral anti-cancer therapies, including assessment of usage and storage of drugs at home, early detection of toxicities leading to better concordance and adherence, and 24-hour telephone access to a chemotherapy nurse. A study conducted at the Christie Hospital, Manchester, compared the outcomes in a group of patients with colorectal or breast cancer who were receiving oral capecitabine and were randomly assigned to 18 weeks of home care or standard hospital care. Patients assigned to home care fared substantially better in terms of symptoms and number of unplanned in-patient days (57 versus 167 days, respectively).8
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Discussion.