Introduction: LAN, a somatostatin analogue, is a common first-line treatment for NETs. LAN comes as a pre-filled, ready-to-use syringe, administered every 4 weeks. In the UK, patients may receive LAN at home. The aim of PREF-NET was to generate real-world evidence describing patients experience of LAN administered in homecare and hospital settings, and the associated impact of treatment setting on other areas of patients lives.
Methods: PREF-NET was a multicentre, cross-sectional, patient-reported study of adults with GEP-NETs in the UK. The study had two parts: a quantitative online patient outcomes survey, and qualitative semi-structured interviews with a subgroup of respondents; here we report data from the online survey. Eligible patients (target, 8090 patients across five clinical sites) were ≥18 years with GEP-NETs receiving a stable dose of LAN at home, but with recent experience in the hospital setting (switched to homecare 424 months earlier). The primary endpoint was overall patient preference for LAN administration at home versus the hospital setting. Secondary endpoints related to impact of treatment setting on healthcare utilisation, societal cost, work productivity, activities of daily living, and health-related quality of life.
Results: The study included 80 patients (mean age 63.9 years [SD 10.6]; 52.0% male. Participants had switched to homecare <6 months (29.5%), 612 months (29.5%) or >12 months (41.0%) prior to the study. In the primary endpoint analysis, 98.7% (95% CI 96.1-100.0) of participants preferred homecare (vs 1.3% [0.03.9] who preferred hospital care). Overall, 84.2% of participants reported that switching to homecare improved overall injection experience while 14.5% reported no change; additional secondary endpoints are reported in table.
|Homecare vs hospital||Somewhat/much better (%)|
|Time (travel, attending appointments)||93.6|
|Confidence in self-management||76.3|
|Ability to plan/go on holiday||80.3|
|Ability to engage in social activities||73.7|
|Relationships with family members/friends||55.3|
|Ability to work||55.4|
Conclusions: In this survey, all but one patient with GEP-NETs receiving LAN preferred to receive their treatment at home versus in hospital, with most indicating that homecare had a positive impact on many other areas of their lives.