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document
Bisphosphonate infusions : patient preference , safety and clinic use . GOALS OF WORK We set out to assess the preference of patients with common cancers involving bone receiving intravenous bisphosphonate therapy for either pamidronate ( P ) or zoledronic acid ( Z ) and their preference for the location of the infusion ( clinic or home ) . We also aimed to monitor these patients ' renal safety , and to compare their time in clinic to receive P and Z infusions . PATIENTS AND METHODS Enrolled in the study were 184 patients , and all received initial infusions of Z ( so any first infusion reactions did not confound preferences for P ) . For their second and third infusions , patients were randomized to receive Z then P or P then Z , and questioned on their preferences . For up to 1 year they continued on Z infusions every 3-4 weeks , while their renal safety was monitored . Where practical , later infusions were given at home ( rather than in the clinic ) and patients questioned on their preferred infusion location . In a convenience subset of 43 patients , clinic use for Z and P infusions was also measured by timing infusions and other procedures . MAIN RESULTS Of 144 patients who received a third infusion , 138 responded to questions on bisphosphonate preference , and of these 138 , 92 % ( 127 ) preferred Z to P , because shorter infusions caused less disruption to their day . Only 12 % of eligible patients ( 16/138 ) received home infusions , but 13/14 questioned preferred this location . Among 184 patients , 19 episodes of renal impairment were noted , mostly owing to disease progression ( e.g . obstructive uropathy ) , with none linked to Z therapy . The mean clinic time taken to receive Z and any concomitant therapy was about half that for P ( 78 vs 161 min ) . CONCLUSIONS Cancer patients prefer shorter bisphosphonate infusions-and at home , where practical . Regular Z 4 mg infusions appear to be safe in these patients , with routine monitoring of serum creatinine . Using Z rather than P could save busy cancer centres time and improve patient satisfaction .
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Intervention_Pharmacological
Bisphosphonate infusions
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Intervention_Pharmacological
bisphosphonate
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Intervention_Pharmacological
pamidronate ( P )
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Intervention_Pharmacological
zoledronic acid ( Z )
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Intervention_Pharmacological
P and Z infusions
16792
Intervention_Pharmacological
infusions of Z
16793
Intervention_Pharmacological
Z then P
16794
Intervention_Pharmacological
P then Z
16795
Intervention_Pharmacological
Z infusions
16796
Intervention_Pharmacological
Z and P infusions
16797
Intervention_Pharmacological
Z
16798
Intervention_Pharmacological
P
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Intervention_Pharmacological
Z
16800
Intervention_Pharmacological
bisphosphonate
16801
Intervention_Pharmacological
Z
16802
Intervention_Pharmacological
Z rather than P
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Outcome_Mental
patient preference
16804
Outcome_Other
safety
16805
Outcome_Other
clinic use
16806
Outcome_Other
renal safety
16807
Outcome_Mental
disruption to their day
16808
Outcome_Physical
renal impairment
16809
Outcome_Physical
disease progression
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Outcome_Other
mean clinic time taken to receive Z and any concomitant therapy
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Outcome_Mental
bisphosphonate infusions-and
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Outcome_Other
safe
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Outcome_Other
patient satisfaction
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Participant_Condition
cancers
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Participant_Sample-size
184
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Participant_Sample-size
12 %
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Participant_Condition
Cancer