title: Symptom management and successful outpatient transplantation for patients with multiple myeloma.
abstract: This retrospective descriptive study compared symptoms and symptom management in patients who completed autologous peripheral blood stem cell transplantation without hospital admission with those of patients who required unplanned hospital admission during the transplantation period. The sample consisted of 87 patients with multiple myeloma treated as outpatients during a 16-month period. Medical records and electronic database records review for each patient provided data on patient characteristics, medical factors, and symptoms/symptom management. Neither age, gender, religion, payer source, treatment on or off protocol, nor positive blood culture made a difference in hospital admission. The percentage of outpatient visits that included documented teaching on self-care made a significant difference (P = .008). Longitudinal analyses of patients' documented symptoms before admission compared with nonadmitted patients captured changes over time in symptoms/symptoms management. Overall, the patients' symptoms were managed well. Significant differences were fatigue, measured as the percentage of usual energy (P = .017), and the amount of oral hydration in a 24-hour period (P < .001). Results call attention to the role that fatigue and the amount of oral hydration may have in unplanned hospital admissions and to the importance of teaching on self-care.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock 72205, USA. colemanann@uams.edu
authors.forename: Elizabeth Ann
authors.initials: EA
authors.lastname: Coleman
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Coon
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Mattox
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Sullivan
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000592:standards*; D001131:Arkansas; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy*; D009325:Nausea / Q000209:etiology / Q000517:prevention & control; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010343:Patient Admission / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000592:standards; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000191:economics / Q000592:standards*; D010865:Pilot Projects; D011788:Quality of Life; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000191:economics / Q000592:standards*; D016896:Treatment Outcome