Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Exploring opportunities to improve supportive service provision for oncology patients undergoing chemotherapy treatment: a secondary analysis of a randomised controlled trial (#435)

Bora Kim 1 , Chantale Boustany 2 , Judith Fethney 3 , Judy M Simpson 4 , Kate White 2
  1. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  2. Cancer Care Research Unit, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  3. School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia
  4. School of Public Health, Sydney University, Camperdown, NSW, Australia

Aims

To examine the common reasons for and potential risk factors associated with unplanned presentations (UPs) in oncology patients undergoing chemotherapy treatment.

 

Methods

The presentation will cover the analysis of longitudinal data from a randomised controlled trial involving adult oncology patients undergoing the first three cycles of chemotherapy at two tertiary hospitals in Sydney, Australia. UPs, such as emergency department visits and unscheduled cancer centre visits, were included in the analysis. Descriptive statistics were used to report the prevalence of and common reasons for UPs. Poisson regression was used to explore sociodemographic and clinical factors associated with UPs. Multivariable analysis was conducted with variables with P<0.2 in univariate analysis.

 

Results

Analyses included data from 346 patients with a mean age of 59 (range 24-97), of whom 223 (64%) were female, 169 (49%) had stage 4 cancers and 145 (42%) had curative intent treatment. 115 patients (33%) made 144 UPs, with most making one (n=91, 79%) UP and the rest (n=24, 21%) making more than one UP.  Of 144 UPs, 67 (46%) were made during cycle 1, and 81 (56%) were chemotherapy-related. The predominant reasons were fever with/without neutropenia (n=50, 35%) and nausea/vomiting (n=30, 21%). Fifty-two percent (n=75) of UPs did not result in hospital admission. Of the 346 patients, 70 (20%) had hospital admissions, with median length of stay 3 days (IQR 2-7). Multivariable analysis identified the following as factors associated with UPs: cancer stage (stage 1 vs stage 4: IRR 2.50, 95% CI: 1.28-4.89; P=0.01) and cancer type (lung cancer vs breast cancer: IRR 2.25, CI: 1.26-4.01; P=0.01).

 

Conclusions

Supportive care provision during chemotherapy may be most beneficial during the first treatment cycle, when most UPs occurred. A high proportion of direct discharges from the emergency department indicates opportunities for reducing UPs through primary or outpatient-based care.