OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press50910.17650/1818-8346-2021-16-4-90-99SUPPORTIVE THERAPY ASPECTSАСПЕКТЫ ПОДДЕРЖИВАЮЩЕЙ ТЕРАПИИKey issues of patient safety during anticancer drug treatment in a day hospital and outpatient settingКлючевые вопросы обеспечения безопасности пациента при проведении противоопухолевого лекарственного лечения в условиях дневного стационара и при амбулаторном режимеhttps://orcid.org/0000-0003-4927-5585FedenkoA. A.ФеденкоА. А.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284, Russia

Россия, 125284 Москва, 2‑й Боткинский проезд, 3

https://orcid.org/0000-0002-6762-9511KolomeytsevaA. A.КоломейцеваА. А.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284, Russia

Россия, 125284 Москва, 2‑й Боткинский проезд, 3

https://orcid.org/0000-0003-3899-8446ArtemovaV. O.АртемоваВ. О.
Russian Federation

Valeriya Olegovna Artemov

3 2nd Botkinskiy Proezd, Moscow 125284, Russia

Валерия Олеговна Артемова

Россия, 125284 Москва, 2‑й Боткинский проезд, 3

valeria.artemova@gmail.comP. A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П. А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России111120211641111202111112021https://oncohematology.abvpress.ru/ongm/article/view/509

Background. In the context of the ongoing COVID-19 pandemic, the vector of healthcare development is aimed at minimizing contacts among citizens, which is especially important for cancer patients, given the immunosuppression caused by cytostatics.

The objective of the review is to present the development prospects of hospital-substituting technologies for drug antitumor treatment. Two main components are considered that allow effective and safe infusion of anticancer drugs in a day hospital: central venous access devices and infusion pumps, various types of these devices, their safety and experience of use today are described.

Materials and methods. We searched for available literature published in PubMed, Medline, eLIBRARY, Cochrane Library, CyberLeninka, Global.health, etc. 42 sources were found and analyzed, published from 2002 to 2021.

Results. Outpatient anticancer drug treatment is a real alternative to hospital stay, based on many years of world experience. The qualifications level of medical personnel involved in the treatment process should allow early monitoring of various adverse events development. With the ongoing COVID-19 pandemic, it is important to ensure the continuity of the treatment process while minimizing risks to the patient.

Conclusion. With a careful approach and adequate infrastructure availability, drug treatment in a day hospital can reduce the burden on round-the-clock stay hospital and positively affect the patients’ quality of life and their compliance with treatment.

Введение. В условиях продолжающейся пандемии COVID-19 вектор развития здравоохранения направлен на минимизацию контактов среди граждан, что особенно важно для онкологических пациентов с учетом иммуносупрессии, вызванной приемом цитостатиков.

Цель обзора – представить перспективы развития стационарзамещающих технологий при проведении лекарственного противоопухолевого лечения. Рассмотрены 2 основных компонента, позволяющих эффективно и безопасно осуществлять инфузии противоопухолевых препаратов в условиях дневного стационара: устройства центрального венозного доступа и инфузионные помпы, описаны различные типы данных устройств, их безопасность и опыт применения на сегодняшний день. Также рассмотрены критерии отбора пациентов, подходящих для амбулаторного лечения.

Материалы и методы. Проведен поиск доступных источников литературы, опубликованных в базах PubMed, Medline, eLIBRARY, Cochrane Library, CyberLeninka, Global.health и др. Было найдено и проанализировано 42 источника, опубликованных с 2002 по 2021 г.

Результаты. Амбулаторное проведение противоопухолевого лекарственного лечения – реальная альтернатива пребыванию в стационаре, основанная на многолетнем мировом опыте. Уровень квалификации медицинского персонала, участвующего в лечебном процессе, должен позволять на ранних этапах отслеживать развитие нежелательных явлений различного генеза. В условиях продолжающейся пандемии COVID-19 важно обеспечить непрерывность лечебного процесса, при этом минимизировав риски для пациента.

Заключение. При тщательном подходе и наличии адекватной инфраструктуры проведение лекарственного лечения в условиях дневного стационара медицинской организации может снизить нагрузку на стационар круглосуточного пребывания и положительно повлиять на качество жизни онкологических пациентов и их приверженность к лечению.

chemotherapyday hospitalquality of lifeport systemsinfusion pumpхимиотерапиядневной стационаркачество жизнипорт-системыинфузионная помпаSekacheva M.I., Rusanov A.S., Fatyanova A.S. et al. Features of cancer patients management during the COVID­19 pandemic. Sechenovskiy vestnik = Sechenov Medical Journal 2020;11(2):62–73. (In Russ.). DOI: 10.47093/2218­7332.2020.11.2.62­73.Секачева М.И., Русанов А.С., Фатьянова А.С. и др. Особенности ведения онкологических пациентов во время пандемии коронавирусной инфекции COVID­19. Сеченовский вестник 2020;11(2):62–73.Evans J.M., Qiu M., MacKinnon M. et al. A multi­method review of home­based chemotherapy. Eur J Cancer Care (Engl) 2016;25(5):883–902. DOI: 10.1111/ecc.12408.Mcilfatrick S., Sullivan K., Mckenna H., Parahoo K. Patients’ experiences of having chemotherapy in a day hospital setting. J Adv Nurs 2007;59:264–73. DOI: 10.1111/j.1365­2648.2007.04324.x.Mak S.S.S., Hui P.Е., Wan W.M.R., Yih C.L.P. At­home chemotherapy infusion for patients with advanced cancer in Hong Kong. Hong Kong J Radiol 2020; 23(2):122–9. DOI: 10.12809/hkjr2017181.Yih P., Mak S. Ambulatory home chemotherapy programme – a success story. 2021. Available at: https://specialty.mims.com/topic/ambulatory­home­chemotherapy­programme/ (access date 28.04.2021).Newton C., Ingram B. Ambulatory chemotherapy for teenagers and young adults. Br J Nurs 2014;23(4):S36–42.Cavallo J. How the COVID­19 pandemic is propelling the delivery of home care for patients with cancer. A conversation with Justin E. Bekelman, MD. Available at: https://ascopost.com/issues/may­25­2020/how­the­covid­19­pandemic­is­propellingthe­delivery­of­home­care­for­patientswith­cancer/ (access date 28.04.2021).Joo E.H., Rha S.Y., Ahn J.B., Kang H.Y. Economic and patient­reported outcomes of outpatient home­based versus inpatient hospital­based chemotherapy for patients with colorectal cancer. Support Care Cancer 2011;19(7):971–8. DOI: 10.1007/s00520­010­0917­7.Schoffski P., Cerbone L., Wolter P. et al. Administration of 24­h intravenous infusions of trabectedin in ambulatory patients with mesenchymal tumors via disposable elastomeric pumps: an effective and patient­friendly palliative treatment option. Onkologie 2012;35(1–2):14–7. DOI: 10.1159/000335879.Toma S., Palumbo R., Comandone A. et al. Ambulatory 4­day continuousinfusion schedule of high­dose ifosfamide with mesna uroprotection and granulocyte colony­stimulating factor in advanced solid tumours: a phase I study. Ann Oncol 1995;6(2):193–6. DOI: 10.1093/oxfordjournals.annonc.a059118.Lee Y.M., Hung Y.K., Mo F.K.F., Ho W.M. Comparison between ambulatory infusion mode and inpatient infusion mode from the perspective of quality of life among colorectal cancer patients receiving chemotherapy. Int J Nurs Pract 2010;16(5): 508–16. DOI: 10.1111/j.1440­172X.2010.01876.x.Ambulatory Care. Hospitals NHSTLT, 2021. Available at: http://www.leedsth.nhs.uk/a­z­of­services/leeds­cancer­centre/your­treatment/chemotherapy/ambulatory­care/ (access date 28.04.2021).Kondo S., Shiba S., Udagawa R. et al. Assessment of adverse events via a telephone consultation service for cancer patients receiving ambulatory chemotherapy. BMC Res Notes 2015;8:315. DOI: 10.1186/s13104­015­1292­8.Kayyali R., Hesso I., Mahdi A. et al. Telehealth: misconceptions and experiences of healthcare professionals in England. Int J Pharm Pract 2017; 25(3):203–9. DOI: 10.1111/ijpp.12340.Odeh B., Kayyali R., Nabhani­Gebara S., Philiр N. Optimizing cancer care through mobile health. Support Care Cancer 2015;23(7):2183–8. DOI: 10.1007/s00520­015­2627­7.Hawasli S.D.R., Nabhani­Gebara S. Optimizing the role of ambulatory chemotherapy in response to the Covid­19 pandemic covid­19 pandemic. J Oncol Pharm Pract 2020;26(8):2011–4. DOI: 10.1177/1078155220963527.Dinnes J., Deeks J.J., Chuchu N. et al. Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults. Cochrane Database Syst Rev 2018;12(12):CD013191. DOI: 10.1002/14651858.CD013191.Sousa B., Furlanetto J., Hutka M. et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol 2015;26(Suppl 5):v152–68. DOI: 10.1093/annonc/mdv296.O’Grady N., Alexander M., Burns L.А. et al. Guidelines for the prevention of intravascular catheter­related infections. Clin Infect Dis 2011;52(9):e162–93. DOI: 10.1093/cid/cir257.LeVasseur N., Stober C., Daigle K. et al. Optimizing vascular access for patients receiving intravenous systemic therapy for early­stage breast cancer – a survey of oncology nurses and physicians. Curr Oncol 2018;25(4):e298–304. DOI: 10.3747/co.25.3903.Catheters and Ports in Cancer Treatment. American Society of Clinical Oncology (ASCO). Conquer Cancer, 2020. Available at: https://www.cancer.net/navigatingcancer­care/how­cancer­treated/chemotherapy/catheters­and­portscancer­treatment (access date 28.04.2021).Boschi R., Rostagno E. Extravasation of antineoplastic agents: prevention and treatments. Pediatr Rep 2012;4(3):e28. DOI: 10.4081/pr.2012.e28.Kreidieh F.Y., Moukadem H.A., El Saghir N.S. Overview, prevention and management of chemotherapy extravasation. World J Clin Oncol 2016; 7(1):87–97. DOI: 10.5306/wjco.v7.i1.87.Injection Site Reactions. Available at: http://chemocare.com/chemotherapy/side­effects/injection­site­reactions.aspx (access date 28.04.2021).Annex I. Summary of product characteristics. Available at: https://www.ema.europa.eu/en/documents/product­information/yondelis­epar­product­information_en.pdf (access date 28.04.2021).Schiffer C.A., Mangu P.B., Wade J.C. et al. Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2013;31(10):1357–70. DOI: 10.1200/JCO.2012.45.5733.Continuous infusion with your elastomeric pump. Available at: https://www.mskcc.org/cancer­care/patient­education/continuous­infusion­elastomeric­pump (access date 28.04.2021).Taking medication with a portable infusion pump: Central venous catheter without valve. Available at: http://csssl.asp.visard.ca/GED_CL/104310292259/Brochureantibio.pdf (access date 28.04.2021).Guidelines for the care of venous catheters for the administration of anticancer medication. Available at: https://www.uhb.nhs.uk/Downloads/pdf/CancerPbVenousCathetersForAnticancerMedication.pdf (access date 28.04.2021).Connected Care Quick Hits. Central Venous Access Devices. Available at: https://www.connectedcare.sickkids.ca/quick­hits/category/Central+Venous+Access+Devices (access date 28.04.2021).Kornbau C., Lee K.C., Hughes G.D., Firstenberg M.S. Central line complications. Int J Crit Illn Inj Sci 2015;5(3):170–8. DOI: 10.4103/2229­5151.164940.Briko N.I., Bikkulova D.Sh., Brusina E.B. et al. Prevention of catheter­associated bloodstream infections and care of the central venous catheter (CVC). Clinical guidelines. Nizhny Novgorod: Remedium Privolzh’e, 2017. 44 p. (In Russ.).Брико Н.И., Биккулова Д.Ш., Брусина Е.Б. и др. Профилактика катетер­ассоциированных инфекций кровотока и уход за центральным венозным катетером (ЦВК). Клинические рекомендации. Нижний Новгород: Ремедиум Приволжье, 2017. 44 с.Madani N., Rosenthal V.D., Dendane T. et al. Health­care associated infections rates, length of stay, and bacterial resistance in an intensive care unit of Morocco: findings of the International Nosocomial Infection Control Consortium (INICC). Int Arch Med 2009;2(1):29. DOI: 10.1186/1755­7682­2­29.Romanova N.I., Budanova E.V., Spirina T.S. et al. Biofilm­forming ability in hospital microorganisms. Nosocomial infections in hospitals of various profiles, prevention, treatment of complications. Materials of the X scientific and practical conference. Moscow, 2012. Pp. 58–59. (In Russ.).Романова Н.И., Буданова Е.В., Спирина Т.С. и др. Способность к биопленко образованию у госпитальных микроорганизмов. Внутрибольничные инфекции в стационарах различного профиля, профилактика, лечение осложнений. Материалы X научнопрактической конференции. М., 2012. С. 58–59.O’Grady N., Alexander M., Burns L.А. et al. Guidelines for the prevention of intravascular catheter­related infections, 2011. Available at: https://www.cdc.gov/infectioncontrol/pdf/guidelines/bsiguidelines­H.pdf (access date 28.04.2021).Dorr R.T., Trinca C.E., Griffith K. et al. Limitations of a portable infusion pump in ambulatory patients receiving continuous infusions of anticancer drugs. Cancer Treat Rep 1979;63(2):211–3.Backler C. Which Ambulatory Infusion Pump Is Best for 5­FU? 2019. Available at: https://voice.ons.org/news­and­views/which­ambulatory­infusion­pump­is­bestfor­5­fu (access date 28.04.2021).Baxter: Operator’s Manual: Sigma spectrum infusion pump with master drug library: 35700BAX2: Pump Operating Software Version 8.00 For use with Master Drug Library Version. Available at: https://training.sigmapumps.com/Documents/41018v0800_Rev_B_Operators_Manual_12_10_14.pdf (access date 28.04.2021).Ohashi K., Dalleur O., Dykes P., Bates D.W. Benefits and risks of using smart pumps to reduce medication error rates: a systematic review. Drug Saf 2014;37(12):1011–20. DOI: 10.1007/s40264­014­0232­1.CADD­Solis Ambulatory Infusion System, 2021. Available at: https://www.smiths­medical.com/products/infusion/ambulatory­infusion/ambulatoryinfusion­pumps/caddsolis­ambulatoryinfusion­pump (access date 28.04.2021).Ehrmann S., Delpech M., Fusciardi J. Influence of temperature on the flow rate of BaxterTM elastomeric infusion pumps. Eur J Anaesthesiol 2004;21:106.Wang J., Moeller A., Ding Y.S. Effects of atmospheric pressure conditions on flow rate of an elastomeric infusion pump. Am J Health Syst Pharm 2012;69(7): 587–91. DOI: 10.2146/ajhp110296.Skryabina E.A., Dunn T.S. Disposable infusion pumps. Am J Health Syst Pharm 2006;63(13):1260–8. DOI: 10.2146/ajhp050408.Baxter: Elastomeric Products: Healthcare professional guide. Available at: https://webcache.googleusercontent.com/search?q=cache:8XMvMs0Y55EJ:https://www.baxterprofessional.com.au/system/files/2018­03/ElastomericProducts_ProfessionalGuide.pdf+&cd=1&hl=ru&ct=clnk&gl=ru (access date 28.04.2021).Your Ambulatory infusion pump (AIP), 2021. Available at: https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/Your_Ambulatory_Infusion_Pump_AIP.pdf#search=Your%20Ambulatory%20Infusion%20Pump (access date 28.04.2021).Baxter infusor range: Patient guide. Available at: https://www.thehomecalling.com/system/files/2019­03/Patient_Guide_Infusors.pdf (access date 28.04.2021).Infusion Pumps. Available at: https://www.fda.gov/medical­devices/general­hospitaldevices­and­supplies/infusion­pumps (access date 28.04.2021).White Paper: Infusion Pump Improvement Initiative. Center for Devices and Radiological Health: U.S. Food and Drug Administration. Available at: https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/GeneralHospi talDevicesandSupplies/InfusionPumps/ucm205424.htm (access date 28.04.2021).Fluorouracil error ends tragically, but application of lessons learned will save lives. Available at: https://www.ismp.org/resources/fluorouracil­error­endstragically­application­lessons­learnedwill­save­lives (access date 28.04.2021).Grissinger M. Fluorouracil mistake ends with a fatality: applying the lessons learned can save lives. P T 2011;36(6):313–4.Grissinger M. Accidental overdoses involving fluorouracil infusions. P T 2018;43(6):316–35.Rowe M., Valle J.W., Swindell R. et al. New face for a familiar friend: the deGramont regimen in the treatment of metastatic colorectal cancer given as an outpatient: a feasibility study. J Oncol Pharm Pract 2002;8(2–3):97–103. DOI: 10.1191/1078155202jp092oa.New Study in Hong Kong Shows Home Ambulatory Chemotherapy Improves Cancer Patient’s Quality of Life. Available at: https://en.prnasia.com/releases/apac/new­study­in­hong­kongshows­home­ambulatory­chemotherapyimproves­cancer­patient­s­quality­oflife­262441.shtml (access date 28.04.2021).