Is a nurse-led telephone intervention a viable alternative to home care and standard care for patients receiving at home chemotherapy treatment?

Home care nursing has been shown to be a valuable service for patients receiving oral chemotherapy; however,
associated costs can be high and telephone-based services may be more cost-effective options. This prospective
audit explored the usefulness of a nurse-led telephone intervention for supporting cancer patients treated with
Capecitabine, comparing historical findings from a randomised trial evaluating a home-based intervention over
standard care with a modified nurse-led telephone follow-up intervention. Self-reported toxicity and service
use were assessed in 298 patients who received nurse-led telephone follow-up, compared with historical data
from 164 patients (81 receiving standard care and 83 home care intervention). Findings suggested that nurse-led
telephone follow-up can potentially lead to reduced toxicity (chest pain, vomiting, oral mucositis, nausea,
insomnia) when compared with standard care, and that it has a similar impact on the management of some
symptoms when compared with home care (i.e. vomiting, oral mucositis), although it was not as effective as
the home care intervention for other toxicities (diarrhoea and insomnia). These encouraging findings need to
be explored further using a randomised trial design before we reach any conclusions. Further research should
also include a health economics study to assess the cost-effectiveness of the telephone-based services for
patients receiving oral chemotherapy.