Our research team in Home Chemotherapy Research Group (i.e., M.D. Pichai Junsriwong, Suwan Sirilerttrakul, Manmana Jirajaras, and other 6 members) at Cancer Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, visited the National Cancer Centre Singapore for 4 days (18-21 August 2015), with the aims of learning and inspecting the home chemotherapy and TPN management.
The research team visited the outpatient chemotherapy unit and the chemotherapeutic preparation unit of pharmacist at the National Cancer Centre Singapore and the Parkway Cancer Centre (a private hospital with tertiary care service) that serve for outpatients and home chemotherapy patients. The observed TPN Management is initiated with the thorough diagnosis and assessment of pateints and their relatives who wish to have home chemotherapy for the first time by physician. Then, the physician provides apparently the treatment instructions. In the nursing step, patients and their relatives must obtain knowledge on how to take care themselves, when having home chemotherapy. Next, the chemotherapeutic medicine prepared by pharmacist will pass to nurse, who will dose the patients through central venous catheter (CVC) and connect with dosing equipment plus chemotherapeutic medicine for continuous treatment at home. Fluorouracil is the most common chemotherapeutic medicine used.
The aims of home chemotherapy is focused on giving important advices that encourage patients and their relatives to participate in having responsibility for assessing the problems that may occur at home, and providing full accessibility in contacting nurse whenever they need helps and advices. The home chemotherapy through CVC is also available at the National Cancer Centre Singapore, while the chemotherapeutic medicines comprise of doxorubicin, vincristine and cytarabine. For the dosing equipments at home, either elastomeric pump or battery-pump have been used by the National Cancer Centre Singapore. When the chemotherapeutic medicine is gone, the patients must visit the hospital for maintaining the CVC and its associated equipments and take heparin treatment.