Chemotherapy Infusion Preference Survey (CHIPS): Patient Preferences for Chemotherapy Scheduling (#322)
Chemotherapy suites face increasing capacity constraints, which limit efficient delivery of treatment. One measure of mitigating such constraints is scheduling patients for treatment on a subsequent day to their medical oncology outpatient appointment (OPA). The objective of the survey was to assess patient preference for chemotherapy on the same day (TSD), or other day (TOD) to their OPA. Secondary aims were to profile socio-economic, cancer, physical, geographic and transportation factors thought to be important to their preference. Preferred chemotherapy delivery time was also surveyed.
The sample size to detect a majority treatment scheduling preference of 60% with 80% power and 5% significance was 194. Patients (n=198) from two major tertiary centres in Perth at Sir Charles Gairdner Hospital (n=110) and Royal Perth Hospital (n=88) completed the survey from 15 April to 25 May 2013. Eligibility criteria included any adult cancer patient receiving an intravenous chemotherapy or biologic agent, and completion of two or more cycles of treatment. Patients completed the survey whilst receiving treatment.
The majority of patients preferred TSD (85.3%, 162/190 patients) versus TOD (14.7%). “Convenience” (50%, 81/162), and “distance or difficulty” in transportation to hospital appointments (24.7%, 40/162) were cited as the most common reasons for TSD. Current treatment schedule (OR=59.2, 95%CI 18.7-265.2) was significantly associated with treatment schedule preference. Presence of a household dependent (OR=4.2, 95%CI 1.2-27.1) and breast cancer (OR=4.9, 95%CI 1.6-21.2) were associated with a preference for TSD. Treatment intent, Karnofsky status, employment, travel time, mode of transport, and acceptable waiting time were not significant factors in preference. Almost all patients preferred chemotherapy delivery before 2 PM (99.5%, 182/183).
Patients preferred chemotherapy on the same day as their medical oncology outpatient appointments. Morning delivery of chemotherapy was also preferred. Meeting patients’ expectations will present significant challenges to efficient service provision as caseload increases.