Aim: To evaluate the plausibility of home administration subcutaneous bortezomib for patients who prefer not to attend the centre due to personal reasons.
Background: Patients receiving chemotherapy treatments in rural centres often find the travel to and waiting times for treatment impact on their quality of life. Some patients wish to continue working or have other duties such as caring for children and other dependents. Home chemotherapy provides another option that may improve their cancer journey.
Weekly bortezomib was selected as it is given as a subcutaneous injection and is relatively easy to be administered.
Methods:
Weekly bortezomib (eviQ 1562)1 was chosen.
Potential patients were identified and screened for eligibility by the Haematology CNS; Discussion with patient about interest to self-administer; Training conducted as per protocol; Consent and an agreement to adhere to treatment instructions was signed.
Prior to each cycle, the patient was reviewed by the haematologist, who at their discretion, approved 2-4 weeks of treatment. The ready-made injections and additional treatment medications were collected by the patient together with a schedule with clear instructions from pharmacy. Each week, the day prior to administration, the CNS would review pathology and ring patient to perform wellness check and advise if okay to go ahead.
Results: 2 patients were enrolled over one year. None failed competency test. Patient satisfaction survey were completed and feedback was very positive. One patient however, remarked that he missed interaction with centre staff. No reported adverse events noted.
Conclusion This option was not without issues. Site faced unexpected issues (e.g. limited time to implement/ train patients; haematologist reluctance to enroll patients; storage conditions in the home environment not checked by Oncology staff). However, this does seem like a promising option for patients preferring to decrease time spent in treatment centre and a formal policy and implementation.