530P_PR Evaluation of quality of supportive care in cancer patients receiving chemotherapy: An experience from a developing country

Abstract

Background Supportive care is essential in cancer patients to prevent and manage drug related toxicities. This study was conducted to assess the quality of supportive care prescribed to patients on cancer chemotherapy. Methods This was a prospective study conducted for a period of six months at a private cancer center. Medical records of the patients on chemotherapy were reviewed and patients were interviewed during the study period to study the prescribed supportive care. Evaluation of supportive care included reviewing use of anti-emetics, colony stimulating factors (CSF), analgesics, antibiotics and protein supplements. Use of supportive care was reviewed with respect to standard recommendations and clinicians’ consensus of the study hospital. Results A total of 850 patients were enrolled in this study. The majority of patients on highly emetogenic regimen (48%) were prescribed with a combination of metoclopramide and dexamethasone followed by combination of ondansetron and dexamethasone (46%). Use of neurokinin receptor antagonist was highly restricted (6%) due to their unaffordability to patients. Only 144 (30%) of 480 patients who were on highly myelosuppressive chemotherapy were prescribed with prophylaxis with filgrastim or pegfilgrastim. CSF is not reimbursed for patients under government schemes and so its use was highly restricted (28 of 294 patients) despite the need. The majority of the patients were prescribed with tramadol with or without non-steroidal analgesics (86%) for cancer related pain. Use of opioids like morphine was limited due to drug shortages at pharmacy. Ceftriaxone and cefoparazone were commonly used antibiotics for prevention and actual treatment of neutropenic fever. Protein supplements were prescribed fairly (76%) for patients under private insurance whereas they were prescribed rarely (14%) for patients under government insurance schemes. Conclusions Poor supportive care delayed treatment schedules due to drug toxicities in our patients. The majority of patients treated under government schemes had poor quality of supportive care while on chemotherapy due to highly restricted provision for the use of supportive care which informs the need for improving the treatment policies at government level. Legal entity responsible for the study N/A Funding N/A Disclosure All authors have declared no conflicts of interest.