Implementation of a telechemotherapy center in the Peruvian jungle to improve patients' quality of life.

Abstract

6547 Background: Instituto Nacional de Enfermedades Neoplásicas (INEN) is located in Lima (capital of Peru). There are no oncologists in regions like Peruvian jungle. Approximately 6% of medical attentions at INEN are people from this cities; so they must spend money and time to receive their treatment far from their cities. The purpose was to implement a module of outpatient chemotherapy in a non-specialized hospital, located in Peruvian jungle, for chemotherapy administration monitored by oncologists from INEN through the use of information and communication technologies (ICT). Methods: Two working teams were organized by formal agreement between INEN and local authorities to properly implement the infrastructure and to train local staff from December 2014 to November 2015. Questionnaire EORTC QLQ-C30 (v3) was used to assess QoL at the beginning and 3 months later. Results: A chemotherapy room with 18 armchairs, an area with a laminar flow hood to mix drugs at pharmacy, and videoconferencing equipment were implemented in Lamas, San Martin (1100 Km from Lima). Two general practitioners, 3 nurses and a pharmacist from Lamas, were trained during 3 months at INEN. Since November 2015, 31 patients were admitted. They received 181 cycles of chemotherapy in 248 rounds of administration, monitored by teleconference. Additionally 227 videoconference meetings to evaluate patients and to coordinate with local team were performed. Global health status improved from 76.67% to 83.33%. We observed benefit in functional scales, likewise symptoms related to disease did not vary, nevertheless financial difficulties decreased from 33.3% to 6.67%. In terms of money and time, this meant an average saving of $150.00 and 4 hours of travel time. Conclusions: Using ICT, we successfully implemented a tele-chemotherapy module in the heart of Peruvian jungle without harming patients quality of life. They will not need to travel to Lima for receiving their treatment.