title: Patients' experience of ambulatory self-administration of pamidronate in multiple myeloma.
abstract: The aim was to explore ambulatory self-administration of Pamidronate (Self-A-Pam) from a patient perspective in patients with multiple myeloma. Pamidronate is normally administered once a month as an intravenous infusion over 2 to 4 hours. Twenty-one patients were included, of whom 13 (6 women, 7 men) with a median age of 56 years (range 37-70) completed the educational program and subsequent ambulatory Self-A-Pam. An RN at the hospital initiated the Pamidronate therapy (90 mg). The patients then left hospital and later, on completion, they disconnected the infusion, either alone or with the assistance of a relative or significant other. Interviews were used to collect information about the experiences during the course of the Self-A-Pam. In total, 12 patients were interviewed after 3 doses of Self-A-Pam. One patient declined to participate in the interview. A qualitative analysis of the textual data was performed. Five main categories were identified: decision concerning Self-A-Pam, information and education, sources of practical help or support, effects of Self-A-Pam, and feelings and activities in relation to place (hospital, home, or public place). All 13 patients who started on Self-A-Pam went through 3 courses of Self-A-Pam during the study period. Many patients reported a gain in feelings of freedom/independence and time saving. However, some patients reported insufficient education and feelings of anxiety associated with the responsibility of handling the venous access device.
authors.affiliation: Division of Hematology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden. eva.mo.johansson@karolinska.se
authors.forename: E
authors.initials: E
authors.lastname: Johansson
authors.forename: A
authors.initials: A
authors.lastname: Langius-Eklöf
authors.forename: P
authors.initials: P
authors.lastname: Engervall
authors.forename: R
authors.initials: R
authors.lastname: Wredling
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D001294:Attitude to Health; D003657:Decision Making; D004164:Diphosphonates / Q000008:administration & dosage*; D005190:Family / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D018718:Home Infusion Therapy / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000523:psychology; D015404:Nursing Methodology Research; D000077268:Pamidronate; D010353:Patient Education as Topic / Q000458:organization & administration; D011368:Professional-Family Relations; D036301:Qualitative Research; D012646:Self Administration / Q000009:adverse effects / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D000077268:Pamidronate