Multiple myeloma patients can now have their injections for VELCADE®, a chemotherapy drug, administered in the comfort of their home, as part of NCIS' home care programme.
12th November 2015, Singapore - Multiple myeloma patients at the National University Cancer Institute, Singapore (NCIS) can now choose to have their VELCADE® injections administered by a nurse outside the NCIS specialist outpatient clinics. Ten patients have signed up for the three-year pilot programme, named VELCADE® @Home, which is launched in August this year, and 55 home visits have been made as of 31st of October 2015.
"While we have previously extended care to patients to home, it is mainly for transitional care-helping patients to settle in at home after their hospital stay or assisting caregivers to learning to take care of the patient themselves. Now, we are going a step further by providing treatment to patients at home,' said Professor Chng Wee Joo, Director and Senior Consultant at NCIS, and a multiple myeloma specialist who is spearheading the programme.
VELCADE® @Home programme
The chemotherapy treatment Velcade@Home programme is a partnership between NCIS and Johnson & Johnson Pte Ltd, which markets VELCADE® in Singapore, with the objective of enabling cancer care and treatment to be more convenient and accessible for patients.
VELCADE®, also known as Bortezomib, is a chemotherapy drug commonly used to treat multiple myeloma. It is usually administered once a week with four injections per treatment cycle (i.e. day 1; 8; 15; 22). The mode of drug-administer is through a subcutaneous injection, a similar mode to insulin injection for diabetic patients. However, drug preparation takes about an hour, and this procedure extends the waiting time for patients to receive their weekly dose at the hospital. Upon the completion of drug preparation, VELCADE® remains stable for eight hours.
Prior to each visit, a nurse will contact the patient on the same day of the scheduled home visit to perform phone triage if he or she is fit to receive the injection.
Suitable patients are identified by the NCIS doctors, and patients shall be well-informed on the VELCADE® @Home programme. When patients are in the Velcade@Home chemotherapy programme, they are able to reach NCIS nurses via a hotline to address any concerns that they may have.
Mr. Low, a patient diagnosed with multiple myeloma leukemia in August 2015 said, 'From my blood and urine tests, the presence of proteins (biomarkers) suggests multiple myeloma leukemia.' Mr. Low went through a first-cycle of injections at his oncologist's clinic, and he was then introduced to the Velcade@Home programme.
'It is important to monitor patients' responses to VELCADE® which is why doctors have to walk them through the first cycle,' said Professor Chng. Patients' wellbeing and physical assessments were not neglected during the Velcade@Home programme either. Visiting nurses document patients' physical characteristics which include mobility, blood pressure measurement, body temperature, etc. These information are then reviewed by the patients' medical consultants or oncologists.
Ms Kelly Lai, one of the three trained nurses who administers VELCADE® for patients at home said, 'Prior to giving the injection, I examine the patient, and I learn more about his/her environment. To know more about patient's living environment enables us to suggest or recommend health assistance that may help the patient. And also to provide some education and awareness based on their health conditions and disease progression.'
Each visit takes approximately 15 to 30 minutes, three home-visits per month; once a week. The first week of each cycle requires a dose administration at the hospital and a follow-up with the medical consultant.
Continual development of homecare services for cancer patients
'We spent a considerable amount of time to develop this programme as there were many factors to consider,' said Prof Chng. VELCADE® is the selected drug for this programme as it has shown to be effective, stable and well-tolerated among patients with few side effects. A drug generally used to treat multiple myeloma, VELCADE®, fits these criteria, making it a prime candidate for home administration.
Similar initiatives for VELCADE® have been done in Europe and they have shown to benefit patients.1
In 2015, more than 1000 doses of VELCADE® were given to patients in NCIS, and the team is looking forward to increase their existing number of health professionals to benefit more multiple myeloma leukemia patients from Velcade@Home multiple myeloma chemotherapy programme.
Source: NUHS, Singapore
- Meenaghan, Teresa, et al. "Home administration of bortezomib: Making a difference to myeloma patients' lives." European Journal of Oncology Nursing 14.2 (2010): 134-136.