NP-108: Improvement in patient experience with successful implementation of a Velcade at Home program in patients with myeloma

Background Traditionally subcutaneous Velcade is delivered in a day ward environment. To reduce hospital visits for our patients, we introduced a Velcade at Home program (VAH) consisting of two arms; self-injection and general practitioner (GP) delivery. Here we present data on the patient experience outcomes. Methods A Self-Injection Assessment Questionnaire was developed for both GP and self-injection arms, adapted from a previously validated tool (1). The questionnaire elicited respondents’ feelings about GP administration or self-injection using a Likert scale format with free text questions used to evaluate time and cost burden. The questionnaire was completed each week during the first cycle in the chemotherapy day unit, prior to cycle 3 (after one full cycle in the community) and at the end of cycle 4. All data were analysed using descriptive statistics. Results The first 20 patients enrolled onto the VAH Program were consented to the study, with 19 completing the program (15 self-injection, 4 GP). In the self-injection arm 46% (7/15) of patients felt anxious prior to their first dose, this decreased to 0/15 by the end of cycle 4. No participants had difficulty removing the cap, depressing the plunger or administering the injection after their first cycle of training. The time reported to complete the injection was shorter for the self-injection arm when compared to their previous injections at hospital (mean 6 minutes and 280 minutes respectively). Similarly, patients in the self-injection arm reported a reduction in the cost burden associated with attending hospital. Of those who responded, 5/7 reported no costs associated with VAH. Conclusion The VAH program has been very well received with patients appreciating the opportunity to regain some control over their treatment and the potential for significant benefit in time and costs. We have been able to share our resources with 7 sites in Australia and New Zealand to help in the implementation of a similar program