Treatment adherence and patients' acceptance of home infusions with adenosine 5'-triphosphate (ATP) in palliative home care

In preterminal cancer patients, provision of palliative care in the patients' own environment is preferred. The aim of the present study was to evaluate patients' and caregivers' treatment adherence and patients' acceptance of home infusions with adenosine 5'-triphosphate (ATP). Preterminal cancer patients (life expectancy < 6 months) with mixed tumor types were eligible for the study. Patients received a maximum of eight weekly intravenous 8-10 h ATP infusions. Evaluation of treatment adherence was based on registration of protocol deviations and patients' acceptance by structured interviews with patients. Fifty-one patients received a total of 266 intravenous ATP infusions. The infusion protocol was well executed: mean duration similar to 8.30 h, stepwise achievement of the maximum infusion rate within 30 min in 65% of the infusions, and almost no delay in weekly administration. All except one patient were not burdened by the administration of the infusions at home and none of them had felt afraid. The majority of patients found the advantages of the ATP infusions outweighing the disadvantages. However, an important bottleneck in the administration of ATP infusions at home was difficulty in establishing venous access. ATP infusions at home are well accepted by patients. Difficulties in establishing venous access might be reduced by composing specialized home infusion teams working both at the day care center and at home or by adopting an alternative route of venous access.