Safety, Efficacy, and Patient Satisfaction with Initial Peripherally Inserted Central Catheters Compared with Usual Intravenous Access in Terminally Ill Cancer Patients: A Randomized Phase II Study

• Published in: Cancer research and treatment Vol. 53; no. 3; pp. 881 - 888
• Main Authors: Park, Eun Ju, Park, Kwonoh, Kim, Jae-Joon, Oh, Sang-Bo, Jung, Ki Sun, Oh, So Yeon, Hong, Yun Jeong, Kim, Jin Hyeok, Jang, Joo Yeon, Jeon, Ung-Bae
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.07.2021; 대한암학회
• Subjects: Administration, Intravenous - adverse effects; Aged; Aged, 80 and over; Antineoplastic Agents - administration & dosage; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - psychology; Catheterization, Peripheral - statistics & numerical data; Female; Hospices - statistics & numerical data; Humans; Male; Middle Aged; Neoplasms - drug therapy; Neoplasms - psychology; Original; Palliative Care - methods; Palliative Care - psychology; Palliative Care - statistics & numerical data; Patient Satisfaction - statistics & numerical data; Prospective Studies; Terminal Care - methods; Terminal Care - psychology; Terminal Care - statistics & numerical data; Terminally Ill - psychology; Terminally Ill - statistics & numerical data; Treatment Outcome; 의학일반; Palliative care; Terminally ill cancer patients; Peripherally inserted central catheter
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2020.1008

Purpose The purpose of this study was to investigate whether routine insertion of peripherally inserted central catheter (PICC) at admission to a hospice-palliative care (HPC) unit is acceptable in terms of safety and efficacy and whether it results in superior patient satisfaction compared to usual intravenous (IV) access.Materials and Methods Terminally ill cancer patients were randomly assigned to two arms: routine PICC access and usual IV access arm. The primary endpoint was IV maintenance success rate, defined as the rate of functional IV maintenance until the intended time (discharge, transfer, or death).Results A total of 66 terminally ill cancer patients were enrolled and randomized to study arms. Among them, 57 patients (routine PICC, 29; usual IV, 28) were analyzed. In the routine PICC arm, mean time to PICC was 0.84 days (range, 0 to 3 days), 27 patients maintained PICC with function until the intended time. In the usual IV arm, 11 patients maintained peripheral IV access until the intended time, and 15 patients underwent PICC insertion. The IV maintenance success rate in the routine PICC arm (27/29, 93.1%) was similar to that in the usual IV arm (26/28, 92.8%, p=0.958). Patient satisfaction at day 5 was better in the routine PICC arm (97%, ‘a little comfort’ or ‘much comfort’) compared with the usual IV arm (21%) (p <0.001). Conclusion Routine PICC insertion in terminally ill cancer patients was comparable in safety and efficacy and resulted in superior satisfaction compared with usual IV access. Thus, routine PICC insertion could be considered at admission to the HPC unit.