title: Home care versus hospital care in patients with multiple myeloma treated with pamidronate.
abstract: Long-term bisphosphonate therapy has been shown to offer clinical benefit in the management of multiple myeloma. This study sought to explore the feasibility and potential advantages of monthly home-based intravenous infusions of pamidronate in patients with multiple myeloma. In a prospective crossover, multicentre trial, 37 patients were randomly allocated to receive 3 months of treatment with pamidronate given in the home followed by 3 months of treatment with pamidronate given in hospital or vice versa. Results from a patient preference questionnaire indicated most patients preferred treatment at home. Quality-of-life measurement was undertaken using the EORTC QLQ-C30 questionnaire. The results indicated a small, generally consistent, although not statistically significant, trend in favour of home care treatment. Extra nursing specialist time was required for home therapy. Home therapy with pamidronate in patients with multiple myeloma appeared feasible and safe and was preferred by patients in this study.
authors.affiliation: Southampton General Hospital, Southampton SO16 0YD, UK. Alastair.Smith@suhtswest.nhs.uk
authors.forename: Alastair G
authors.initials: AG
authors.lastname: Smith
authors.forename: Richard L
authors.initials: RL
authors.lastname: Soutar
authors.forename: Steven
authors.initials: S
authors.lastname: Schey
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Andrews
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Baister
authors.forename: Carol
authors.initials: C
authors.lastname: Bilbrough
authors.forename: Marie
authors.initials: M
authors.lastname: Connelly
authors.forename: Ann
authors.initials: A
authors.lastname: Joyce
authors.forename: J Anthony
authors.initials: JA
authors.lastname: Child
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001294:Attitude to Health; D018592:Cross-Over Studies; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D018718:Home Infusion Therapy / Q000451:nursing / Q000523:psychology / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000451:nursing / Q000523:psychology; D000077268:Pamidronate; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D000077268:Pamidronate