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增强以患者为中心的护理:化疗引起的中性粒细胞减少症中 G-CSF 给药偏好的随机研究。

Enhancing patient-centered care: a randomized study on G-CSF administration preferences in chemotherapy-induced neutropenia.

机构信息

Rafael Institute, Integrative Medicine Center, Levallois-Perret, France.

Hartmann Oncology Radiotherapy Group, Hartmann Radiotherapy Institute, Levallois-Perret, France.

出版信息

Support Care Cancer. 2024 Oct 22;32(11):743. doi: 10.1007/s00520-024-08929-x.

Abstract

PURPOSE

Chemotherapy-induced neutropenia poses a significant risk to cancer patients, with pegfilgrastim being commonly used for its prevention. While pegfilgrastim can be administered via prefilled syringe or pen device, patient preferences and experiences with these delivery methods remain unclear.

METHODS

We conducted a prospective, open-label, randomized, observational trial (NCT05910164) at the Rafael Institute, France, comparing patient preferences for pegfilgrastim administration using a prefilled syringe versus a prefilled pen device. Patients undergoing chemotherapy and requiring pegfilgrastim were enrolled and randomized 1:1 to receive either syringe or pen first, with crossover administration. Questionnaires assessed patient preferences, learning experiences, autonomy, pain levels, emotional responses, satisfaction with nursing care, and empowerment.

RESULTS

Among 150 randomized patients (mean age 58 years; 69% female), both groups showed a preference for the pen device, with significantly higher mean scores favoring pen administration (4.94 ± 1.70 vs. 4.27 ± 1.84; p = 0.00106). Patients reported significantly lower perceived pain with pen administration and stronger positive emotions compared to syringe use. Satisfaction with nursing care was higher with syringe use. Empowerment levels were similar across groups but significantly stronger when using the pen in complete autonomy.

CONCLUSION

A preference for pegfilgrastim administration via the pen device was observed, though this may have been influenced by the administration sequence and the absence of syringe self-administration. The insights gained can help inform clinical decision-making and improve patient-centered care in managing chemotherapy-induced neutropenia.

TRIAL REGISTRATION

NCT05910164 on June 15, 2023.

摘要

目的

化疗引起的中性粒细胞减少症对癌症患者构成重大风险,常使用培非格司亭预防。培非格司亭可通过预装注射器或笔式装置给药,但患者对这些给药方式的偏好和体验尚不清楚。

方法

我们在法国拉斐尔研究所进行了一项前瞻性、开放标签、随机、观察性试验(NCT05910164),比较了使用预装注射器与预装笔式装置给予培非格司亭时患者的偏好。入组正在接受化疗且需要培非格司亭的患者,并按 1:1 随机分为先接受注射器或笔式装置,然后交叉给药。问卷调查评估了患者的偏好、学习体验、自主性、疼痛程度、情绪反应、对护理的满意度、赋能感。

结果

在 150 名随机患者中(平均年龄 58 岁;69%为女性),两组均更倾向于使用笔式装置,使用笔式装置的平均评分明显更高(4.94±1.70 对 4.27±1.84;p=0.00106)。与使用注射器相比,患者报告使用笔式装置时疼痛明显减轻,情绪更积极。对护理的满意度随注射器的使用而提高。赋能感在两组间相似,但在完全自主使用笔式装置时更强。

结论

观察到患者更倾向于使用笔式装置给予培非格司亭,但这可能受到给药顺序和缺乏注射器自我给药的影响。这些发现有助于为管理化疗引起的中性粒细胞减少症提供临床决策依据,并改善以患者为中心的护理。

试验注册

NCT05910164 于 2023 年 6 月 15 日注册。

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