​ABOUT NCCS HOME CARE

The National Cancer Centre Singapore (NCCS) continually strives to provide patient care of the highest standards. A recent addition to its comprehensive suite of clinical services is NCCS Home Care, launched in July 2020, which enables patients to receive a selected range of cancer treatments at home.

BENEFITS OF HOME CARE

1. Accessibility and convenience
The advantages are many, especially for patients who are less mobile and require supervision or special travel arrangements by ambulance. As it makes cancer care more accessible and convenient, patients are less likely to miss their treatments.

2. Personalised care
The programme delivers care in the comfort and familiarity of the patient’s home, providing individualised care and optimising quality of life. This resonates strongly with NCCS’ aim to personalise care.

3. Reduced exposure risk
With the COVID-19 pandemic and safe distancing measures in place, NCCS Home Care fulfils the Ministry of Health’s (MOH) aim to reduce clustering of patients at healthcare institutions.

4. Opportunity cost savings
In addition, it offers savings in opportunity costs, such as patients’ and their caregivers’ waiting times at NCCS, the need to take leave from work, as well as travel expenditure to and from NCCS.

5. Optimises operational capacity
By redirecting patients whose care may be delivered at home, there are institutional capacity gains in delivering care that can only be done at NCCS.

OUR SUCCESSFUL PILOT:
Subcutaneous Trastuzumab For Breast Cancer

A pilot study on administering subcutaneous (SC) Herceptin® (Trastuzumab) at home for breast cancer patients has shown that home care is popular and well-received, with feedback indicating that patients are ‘satisfied’ or ‘very satisfied’. No safety issues were flagged.

Background
Trastuzumab is a drug used to treat breast cancer that is HER2-positive. HER2-positive breast cancer constitutes about 15% of all breast cancer cases. It is used in the (neo)adjuvant and metastatic settings, where it is typically given over one year (adjuvant) and more than one year cumulatively (metastatic).

Intravenous vs. subcutaneous treatment options
Intravenous (IV) Trastuzumab requires multiple three-weekly visits to a cancer centre where its administration lasts an hour, but the total visit duration is more than an hour due to waiting times.

The long-term administration of intravenous Trastuzumab may require indwelling intravenous catheters, which presents its own host of risks (e.g., infection, blood clots), and financial costs (e.g., line insertion/removal, hospitalisations).

Subcutaneous Trastuzumab is a fixed dose of 600 mg. It is amenable to administration at home without needing intravenous catheters. However, as the medication requires reconstitution, it cannot be self-administered.

Studies have been conducted which demonstrate equivalent efficacy and similar safety profiles between SC Trastuzumab and IV Trastuzumab.

OTHER AVAILABLE HOME CARE TREATMENTS

With the positive feedback received, NCCS Home Care has been expanded to include the following treatments:

• Hormonal therapy (e.g., Goserelin, Leuprorelin, Degarelix, Fulvestrant)
• Granulocyte colony stimulating factors (e.g., Filgrastim, Pegfilgrastim)
• Bone modifying agents (e.g., Denosumab)

BEYOND HOSPITAL TO COMMUNITY

NCCS Home Care is an extension of NCCS’ repertoire of clinical services in line with MOH’s call to transform healthcare beyond hospital to community, beyond healthcare to health and beyond quality to value.

NCCS is always looking out for opportunities to engage with healthcare professionals in the community to provide better cancer care for patients.

For NCCS Home Care where treatment is administered at home, doctors in nearby clinics may be called upon in the event of a medical emergency, to assist patients who experience any adverse drug reactions.

NCCS Home Care is a joint endeavour with JagaMe, a home care provider whose team of trained nurses visits the patients at home to administer treatment. To ensure patient safety, nurses administering the injections are required to undergo rostered routine testing for COVID-19, as with other healthcare workers in Singapore.

NCCS Home Care is headed by Dr Elaine Lim, Senior Consultant, Department of Breast and Gynaecology, Division of Medical Oncology, NCCS.

For enquiries on NCCS Home Care, please contact NCCS at:
Tel: 6436 8288
Email: [email protected]