Poster Presentation COSA 2015 ASM

Patient Factors that Influence Outpatient Chemotherapy Delivery Scheduling Preferences (#323)

Peter K H Lau 1 2 , Siao-Nge Hoon 3 , Jade Newton 4 , Scott G Taylor 4 , Joseph P McTigue 4 , Arman Hasani 5 , Claire Johnson 6
  1. Department of Health Western Australia, Perth, Western Australia, Australia
  2. Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
  3. Royal Perth Hospital, Perth, Western Australia, Australia
  4. University of Western Australia, Nedlands, Western Australia, Australia
  5. Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  6. Cancer and Palliative Care Research and Evaluation Unit, University of Western Australia, Nedlands, Western Australia, Australia

Aims

To meet service demand, chemotherapy day units may schedule patients to receive infusions on an alternate day to their medical oncology outpatients’ appointment (TOD). Our previous survey indicated patients prefer treatment on the same day as their outpatient appointment (TSD) with a possible bias towards their existing treatment schedule. We performed a confirmatory study on patient preferences for outpatient chemotherapy scheduling with secondary aims to profile socio-economic, transport, cancer and delivery factors thought to be relevant.

Methods

Patients from three major tertiary public hospitals in Perth completed the survey and were stratified according to their existing treatment schedule (TSD or TOD). A minimum sample size to detect a majority preferred treatment schedule of 60% with 80% power and significance level of 5% being 194 respondents for each cohort. Eligibility criteria included any adult cancer patient receiving an intravenous chemotherapy or biologic agent and completion of at least one treatment cycle. Patients completed the survey whilst receiving their intravenous infusion.

Results

A total of 432 patients (231 TSD, 198 TOD, 3 indeterminate schedule) completed the survey between 5/5/2014-26/9/2014. The majority of patients preferred TSD over TOD (76.8%). Patients allocated TOD had no preference in scheduling (51% TSD), whereas TSD patients heavily preferred their existing schedule (99%). “Convenience” and “distance” were cited for preferring TSD by 58% and 23% of respondents respectively. Patients preferring TSD had longer median travel times (40 vs 30 min, p=0.003). Non-metropolitan patients preferred TSD (OR=2.39,95%CI:1.18-4.85). Rural patients had a median travel time of 130 minutes and preferred TSD (OR=2.86,95%CI: 1.10-7.43). Maximum waiting time for chemotherapy of 90 minutes was an independent predictor of TSD preference (p=0.014).

Conclusion

This study confirms patients prefer chemotherapy on the same day as their medical oncology outpatient appointment especially with rural patients and those travelling long distances.