Supportive Care in Cancer

, Volume 20, Issue 11, pp 2755–2764 | Cite as

Health-related quality of life anticipated with different management strategies for febrile neutropenia in adult cancer patients

  • O. Teuffel
  • S. Cheng
  • M. C. Ethier
  • C. Diorio
  • J. Martino
  • C. Mayo
  • R. Wing
  • L. Sung
  • S. M. H. Alibhai
Original Article
First Online:
Received:
Accepted:

Abstract

Purpose

To describe anticipated health-related quality of life (HRQL) for different hypothetical strategies of febrile neutropenia (FN) management in adult cancer patients.

Methods

Seventy-eight adult cancer patients were enrolled. Our study considered four different hypothetical treatment strategies for FN: (1) entire inpatient management with intravenous (IV) antibiotics; (2) oral treatment at home after an initial observation in hospital with IV antibiotics; (3) entire outpatient management with IV antibiotics; and (4) entire outpatient management with oral antibiotics. Initially, patients were asked to rank the different treatment strategies for FN based on their personal preference. Subsequently, HRQL was rated using visual analog scale (VAS), time trade-off (TTO), and willingness-to-pay (WTP).

Results

Seventy-five percent of all respondents preferred an outpatient strategy for FN (36% oral, 21% intravenous, 18% early discharge). Further, outpatient strategies were associated with higher mean VAS scores (possible range 0–10) (oral: 6.1 (standard deviation (SD) 3.1); intravenous: 6.2 (SD 2.2); early discharge: 5.7 (SD 2.1)) as compared to inpatient care (5.3 (SD 2.9)). On the aggregate level, patients were willing to give up between 9 and 10 weeks of their life (TTO; corresponding to <1% of remaining life expectancy) and to pay between $255 and $327 Canadian dollars (WTP) to avoid treatment in hospital.

Conclusions

Our study indicates that the majority of adult cancer patients would prefer an outpatient strategy for FN. However, patients’ preferences vary substantially at the individual level. Implementation of outpatient strategies into routine clinical practice should consider this variability.

Keywords

Fever Neutropenia Quality of life Patient preference Outpatients 
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Notes

Funding Source

A bursary from the Swiss Cancer League supports OT; LS is supported by a New Investigator Award from the Canadian Institutes of Health Research (Grant No. 87719)

Conflicts of interest

SMHA is a Research Scientist of the Canadian Cancer Society. There is no financial disclosure from any author

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • O. Teuffel
    • 1
    • 2
  • S. Cheng
    • 2
  • M. C. Ethier
    • 2
  • C. Diorio
    • 2
  • J. Martino
    • 2
  • C. Mayo
    • 2
  • R. Wing
    • 2
  • L. Sung
    • 2
    • 3
  • S. M. H. Alibhai
    • 3
    • 4
  1. 1.Division of Haematology/OncologyThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Child Health Evaluative SciencesThe Hospital for Sick ChildrenTorontoCanada
  3. 3.Department of Health Policy Management and EvaluationUniversity of TorontoTorontoCanada
  4. 4.Department of Medicine, University Health NetworkToronto General HospitalTorontoCanada

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