Exploring patient perspectives on ambulatory chemotherapy : experiences, challenges, and outcomes

Abstract

Background: Cancer is a leading cause of mortality, with around 2,500 new cases diagnosed annually in Malta, accounting for 27% of all deaths. As demand for chemotherapy rises, healthcare systems explored alternatives like Ambulatory Chemotherapy (AC), which allows patients to receive treatment at home. Introduced in Malta in October 2023, AC represents a significant shift in cancer care. However, no research examined its impact on patients' experiences. This study is the first locally to explore this emerging service. Objectives: The study aims to explore patients' perspectives on AC, focusing on its impact on quality of life, emotional well-being, and overall satisfaction. This study examined key factors such as comfort, convenience, quality of care, and psychological well-being while identifying potential barriers and challenges in accessing AC. Additionally, the study seeks to highlight areas for improvement to optimize service delivery. Methodology: This research adopted a descriptive qualitative approach to achieve its objectives. A purposive sampling method was used to recruit adult patients undergoing AC. Data collection took place between November and December 2024 through semi-structured interviews, which were audio recorded, transcribed verbatim, and analyzed using thematic analysis. Participants: The study included eight participants aged 45 to 70 years, all diagnosed with colorectal cancer. Interviews, lasting 25 to 35 minutes, were conducted with participants at various stages of chemotherapy from the third to twelfth cycle. Results: Six key themes emerged including Patient Empowerment, Emotional Impact, Social Support, Quality of Life, Challenges, and Future Improvements. While patients valued the comfort, privacy and control of treatment, results suggested that patients experience also various challenges in relation to elastomeric pump and work issues due to frequent hospital visits for change of chemotherapy. Conclusion: This research offers valuable insights into patients' experiences with AC, highlighting both its benefits and challenges. Despite its limitations, the study provides a unique perspective on how AC impacts patients' lives. This research paves the way for future studies aimed at optimizing AC services and enhancing patient care, marking an important step in improving home-based cancer treatment delivery.