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Observational Study
. 2024 Nov 29;32(12):834.
doi: 10.1007/s00520-024-09011-2.

Quality of care of oncological patients with home parenteral nutrition

Andrea Schneider  1 , Christina Baur  2   3 , Yurdagül Zopf  4 , Helga Paula Török  5 , Christian Sina  6 , Christian Prinz  7 , Heike Mönnich  8 , Ahmed Madisch  9   10 , Susen Maluck-Schölecke  11 , Ingeborg Rötzer  12 , Claudia Seipt  1 , Anja Götte  1 , Justinus Beer  13 , Elke Jäger  12
Affiliations
Observational Study

Quality of care of oncological patients with home parenteral nutrition

Andrea Schneider et al. Support Care Cancer. .

Abstract

Purpose: Transferring adult cancer patients from the hospital to the home environment for home parenteral nutrition (HPN) can be challenging. There is limited real-world data on how those affected perceive this situation. Our aim was to assess the quality of life (QoL) on HPN and the benefits and burdens from the cancer patient's perspective.

Methods: This observational study from Germany examined the QoL on HPN on the basis of the Functional Assessment of Cancer Therapy - G questionnaire (FACT-G). The benefits and burdens of HPN were assessed using predefined questions and answers tailored to the situation of this patient group.

Results: 139 adults with advanced solid tumors in a palliative setting at 10 hospitals in Germany were eligible for the study. The follow-up was 12 weeks. At week 4, the Least-square (LS) mean (95% CI) change from baseline in the total FACT-G score was 0.9 (-2.4; 4.2) points, indicating QoL stability. HPN was associated with few complications, with a low rate of hospital readmission due to catheter-related issues (3.8%; n = 5). In the patient assessment of the benefits of HPN, the LS mean values at Week 4 ranged between 7.6 and 8.5 on a 10-point Likert scale. The most commonly perceived burden was "restricted mobility".

Conclusion: With thorough preparation for home parenteral nutrition, the transition from hospital to home care environment works well. QoL is largely maintained through HPN, and cancer patients perceive this situation as not or minimally burdensome alongside their underlying disease, although many patients found the limited mobility to be a burden.

Trial registration number: NCT03425435 / Date of registration: February 01, 2018.

Keywords: Cancer; Discharge management; HPN; Home parenteral nutrition; Quality of life; Solid tumor.

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Conflict of interest statement

Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Involved ethics committees (reference number) were: Ethikkommission der Medizinischen Hochschule Hannover (7730_BO_S_2018), Ethikkommission der Friedrich-Alexander-Universität Erlangen-Nürnberg (129_18 Bc), Ethik-Kommission der Landesärztekammer Baden-Württemberg (B-F-2018–031), Ethik-Kommission bei der Landesärztekammer Hessen (MC 266/2018), Ethikkommission der Universität zu Lübeck (18–307), Ethikkommission Ärztekammer Sachsen-Anhalt (68/18), Ethik-Kommission II Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg (2018-644N-MA), Ethikkommission bei der Medizinischen Fakultät der LMU München (18–884), Ethik-Kommission der Universität Witten/Herdecke (199/2018). Consent to participate: Informed consent was obtained from all individual participants included in the study. Competing interests: Elke Jäger and Ingeborg Rötzer report personal fees from Clinic for Oncology and Haematology, Nordwest Hospital, UCT University Center, 60488 Frankfurt, during the conduct of the study. Christian Sina held an endowed professorship from 2016 to 2018. Justinus Beer is an employee of Fresenius Kabi Deutschland GmbH, Bad Homburg/Germany. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Discharge management for home parenteral nutrition (133 patients who started HPN)
Fig. 2
Fig. 2
Summary of categorical questions on the quality of the discharge and outpatient care management answered by patients (139 patients who were eligible for HPN)
See this image and copyright information in PMC

References

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