AIMS AND OBJECTIVES: Our purpose was to assess the effectiveness of a specific home care nursing program (HCNP) in addition to standard care in patients (pts) receiving oral anticancer treatments.
BACKGROUND: Oral anticancer therapy present challenges for pts since treatment is a home-based therapy. This study evaluate the potentiality of a HCNP in decreasing hospital accesses for not severe toxicity.
METHODS: This is an open-label, multicentre, randomized trial including pts who were receiving an anticancer oral drug. The study complies with the CONSORT Checklist published in 2010. Concomitant use of radiation therapy, intravenous or metronomic therapies, or the intake of previous oral drugs were not allowed. Pts were randomly assigned to HCNP (A) or standard care (B). In arm A, dedicated nurses provided information to pts, a daily record on which pts would take note of drugs and dosages and a telephone monitoring during the first two cycles of therapy. The primary outcome was the reduction in improper hospital accesses for grade 1-2 toxicity according to CTC-AE v4.0.
RESULTS: Out of 432 randomized pts, 378 were analysed (184 pts in arm A and 194 in arm B). Hospital accesses were observed in 41 pts in arm A and in 42 pts in arm B (22.3% vs. 21.6%, respectively). No difference was detected in proportion of improper accesses between arm A and arm B (29.3% vs. 23.8%, respectively).
CONCLUSIONS: Our experience failed to support the role of a specific HCNP for pts taking oral chemotherapy. An improved attention to specific educational practice and information offered to pts can explain these results.
RELEVANCE TO CLINICAL PRACTICE: Our results underline the role of nurse educational practice and information offered to patients. A careful nurse information of patients about drugs is essential to reduce toxicities avoiding the opportunity of a specific home monitoring.