title: Effectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy: a randomized, controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a symptom-focused home care program in patients with cancer who were receiving oral chemotherapy in relation to toxicity levels, anxiety, depression, quality of life, and service utilization.
  
  
  METHODS
  A randomized, controlled trial was carried out with 164 patients with a diagnosis of colorectal (n = 110) and breast (n = 54) cancers who were receiving oral capecitabine. Patients were randomly assigned to receive either a home care program by a nurse or standard care for 18 weeks (ie, six cycles of chemotherapy). Toxicity assessments were carried out weekly for the duration of the patients' participation in the trial, and validated self-report tools assessed anxiety, depression, and quality of life.
  
  
  RESULTS
  Significant improvements were observed in the home care group in relation to the symptoms of oral mucositis, diarrhea, constipation, nausea, pain, fatigue (first four cycles), and insomnia (all P < .05). This improvement was most significant during the initial two cycles. Unplanned service utilization, particularly the number of inpatient days (57 v 167 days; P = .02), also was lower in the home care group.
  
  
  CONCLUSIONS
  A symptom-focused home care program was able to assist patients to manage their treatment adverse effects more effectively than standard care. It is imperative that patients receiving oral chemotherapy are supported with such programs, particularly during initial treatment cycles, to improve their treatment and symptom experiences.
authors.affiliation: University of Manchester, School of Nursing, University Place, Manchester, M13 9PL, United Kingdom. alex.molassiotis@manchester.ac.uk
authors.forename: Alex
authors.initials: A
authors.lastname: Molassiotis
authors.forename: Sarah
authors.initials: S
authors.lastname: Brearley
authors.forename: Mark
authors.initials: M
authors.lastname: Saunders
authors.forename: Olive
authors.initials: O
authors.lastname: Craven
authors.forename: Andrew
authors.initials: A
authors.lastname: Wardley
authors.forename: Carole
authors.initials: C
authors.lastname: Farrell
authors.forename: Ric
authors.initials: R
authors.lastname: Swindell
authors.forename: Chris
authors.initials: C
authors.lastname: Todd
authors.forename: Karen
authors.initials: K
authors.lastname: Luker
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000451:nursing* / Q000523:psychology; D000069287:Capecitabine; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000451:nursing* / Q000523:psychology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil