Skip to Main content Skip to Navigation
Master Thesis

Immunothérapie anti-PD1 dans le mélanome en hospitalisation à domicile : enquête de satisfaction auprès des patients et des soignants

Abstract : Introduction: For 10 years, anti-PD1 immunotherapy have revolutionized the management of stage III and IV melanoma with a considerable improvement in prognosis. COVID-19 pandemic disrupted organization of day hospital because of some deprogramming cures, staff reduction of day hospital and the need to limit nosocomial COVID infections. This unprecedented health context motivated the establishment of day hospital-home care pathway, enabling infusions of anti-PD1 at home. Our main hypothesis is that CHUGA patients receiving part of anti-PD1 infusions for melanoma at home are satisfied with this patient care. Methods: This study was realized in two parts: - The first part was prospective, monocentric, with inclusion of all patients with melanoma currently treated or having been treated with anti-PD1 (adjuvant or curative) in day hospital-home care pathway at CHUGA. A satisfaction questionnaire was distributed to the patients and to the hospital and private practitioners of this pathway. - The second part was a multi-centric, to evaluate practice of immunotherapy at home care by a questionnaire sent to the centers of the French group for Cutaneous Oncology. Results: Twenty-six answers were received and 96% of patients were totally or very satisfied with the overall management of immunotherapy at home and 20 patients (77%) would totally or very much recommend immunotherapy at home care to other patients. The main strengths of this care pathway were the time saved and the reduction of travel to the CHUGA. The main potential obstacle according to the patients was the lack of experience of private nurses. The main potential obstacle according to patients was the lack of experience of private nurses. Five doctors were interviewed and all (100%) were completely or very satisfied with the day hospital-home care pathway and were ready to develop it. The main benefit was the saving of time thanks to teleconsultation. 9 private nurses answered the satisfaction questionnaire. 5 nurses (56%) were completely or very comfortable with management of patients on anti-PD1 at home and 4 nurses (44%) were completely or very satisfied with the overall management of patients. Indeed, 7 nurses (78%) would like training on melanoma as well as on anti-PD1 immunotherapy. In France, seventeen centers answered to the questionnaire and 3 centers in addition to the CHUGA practiced immunotherapy at home care. According to their feedback, main positive points were patient satisfaction and freeing up of day hospital places. The main obstacles were decrease in the activity of day hospital, remote management of toxicities and delivery of the treatment by the hospital pharmacy. Conclusion: All patients except one are satisfied with the coordinated management between day hospital and home care for immunotherapy at home. Most of them would recommend this management to other patients. The majority of the health actors involved in this care pathway are also satisfied with this management and are ready to further develop it. Immunotherapy at home care is a new therapeutic option that is satisfactory for patients and their quality of life. It also allows us to respond to the increase in the number of patients treated with immunotherapy.
Document type :
Master Thesis
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03406892
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Monday, November 8, 2021 - 10:54:41 AM
Last modification on : Wednesday, November 10, 2021 - 3:35:08 AM

File

2021GRAL5151_lapassat_marie_et...
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-03406892, version 1

Citation

Marie Lapassat, Thu Thao. Immunothérapie anti-PD1 dans le mélanome en hospitalisation à domicile : enquête de satisfaction auprès des patients et des soignants. Médecine humaine et pathologie. 2021. ⟨dumas-03406892⟩

Share

Metrics

Record views

40

Files downloads

18