Early Discharge and Outpatient Care After Chemotherapy in Patients With Myelodysplastic Syndrome or Acute Myeloid Leukemia
RATIONALE: Gathering information about patients with myelodysplastic syndrome or acute myeloid leukemia who are discharged after finishing chemotherapy, or who stay in the hospital until blood counts return to normal, may help doctors learn more about a patient's quality of life, use of medical services, and the cost of these services.
PURPOSE: This clinical trial is studying early discharge and outpatient care in patients who have undergone chemotherapy for myelodysplastic syndrome or acute myeloid leukemia.
Other: medical chart review
Other: questionnaire administration
Procedure: quality-of-life assessment
|Study Design:||Primary Purpose: Health Services Research|
|Official Title:||Pilot Study of Feasibility, Safety, and Economics of Early Discharge and Outpatient Management of Adult Patients Following Intensive Induction Chemotherapy for Myelodysplastic Syndrome and Non-APL Acute Myeloid Leukemia|
- Death rate in patients discharged after completion of induction chemotherapy [ Designated as safety issue: No ]
- Rate of successful discharge of patients who meet medical discharge criteria [ Designated as safety issue: No ]
- Costs associated with outpatient vs inpatient treatment [ Designated as safety issue: No ]
- Medical resources used with outpatient vs inpatient treatment [ Designated as safety issue: No ]
|Study Start Date:||December 2008|
|Study Completion Date:||March 2011|
|Primary Completion Date:||September 2010 (Final data collection date for primary outcome measure)|
- To compare the death rate in patients with myelodysplastic syndromes or acute myeloid leukemia who are discharged after completion of induction chemotherapy vs those who remain in the hospital until blood counts recover.
- To determine the proportion of patients who meet the early discharge criteria after completion of induction chemotherapy.
- To compare the costs incurred by patients who are discharged early vs those who are discharged only after blood counts recover.
- To compare resource utilization (e.g., transfusions) among these patients.
- To compare the quality of life of these patients.
OUTLINE: Within 72 hours after completion of induction chemotherapy, patients are either discharged from the hospital or remain in the hospital until their blood counts recover.
Patients receive standard supportive care after completion of induction chemotherapy either in the hospital or as an outpatient. Outpatients are seen by a registered nurse or physician assistant ≥ 3 times weekly and by a physician at least once weekly.
A medical chart review is conducted to obtain information about medical complications (e.g., neutropenic fever, documented infections, bleeding, reasons for hospitalization) and use of medical resources. Patients complete the MDA Symptom Inventory and the EORTC QLQ-C30 questionnaire periodically to assess quality of life. Costs associated with inpatient and outpatient care are evaluated using electronic billing information from the University of Washington Medical Center and Seattle Cancer Care Alliance.
After completion of the study, patients are followed up for 1 month.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00844441
|United States, Oregon|
|Oregon Health and Science University|
|Portland, Oregon, United States, 97201-3098|
|United States, Washington|
|Fred Hutchinson Cancer Research Center|
|Seattle, Washington, United States, 98109-1024|
|Clinical Cancer Research Center at University Hospital Basel|
|Basel, Switzerland, CH-4031|
|Principal Investigator:||Roland Walter, MD, PhD||Fred Hutchinson Cancer Research Center|