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Abstract

CHEMOTHERAPY TREATMENT IN THE COMMUNITY-BASED ONCOLOGY UNITS VERSUS TERTIARY ONCOLOGY UNITS: A CROSS SECTIONAL AND OBSERVATORY STUDY

Agbarya Abed M.D., MSc, Taha Tarek M.D., *Prof. Dr. Bowirrat Abdalla M.D., Ph.D., and Youssef Awni M.D. MPH.

ABSTRACT

Introduction: Cancer treatment involves comprehensive multimodality approaches and sometimes lasts for several months. Patients' daily agenda, in oncology care units, is long and exhausting. Such agenda may lead to mental, emotional and physical stresses. In Israel, only 14 oncology units exist, including the day-care facilities based in tertiary hospitals. Establishing community based oncological units may serve as good solution for the shortage of facilities by providing more accessible and available care. Objectives: To compare treatment quality between two oncology unit models: A tertiary and a community-based oncology units in Israel, in terms of treatment schedule and chemotherapeutic drug dosage, as well as the patients overall satisfaction and other psychological parameters. Methods: A cross sectional analytic study was conducted with a cohort of 143 patients; 76 treated in a tertiary center and 67 in a community center, using two validated questionnaires (DIC and HADS) and patients' data file. Results: There was no difference between the two models in terms of therapeutic quality (dose density and intensity) and psychological status in terms of depression or anxiety. However, a significant improvement was observed in distress level, primarily psychologically and spiritually, between patients treated in the community versus the tertiary center (98.55% ± 1.85 vs. 88.84% ± 1.40), respectively, P<0.0001, and in the waiting time for treatment (31.62 ± 6.37 vs. 97.89 ± 6.88 minute) respectively, P<0.0001. Conclusion: The community-based oncology unit model has advantages over tertiary oncology units in terms of distress levels and saving time, without any compromise in therapeutic quality or psychological aspects.

Keywords: Community center, tertiary center, chemotherapy, Depression, Distress.


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