A randomized crossover trial assessing patient preference for two different types of portable infusion-pump devices

Background: A variety of anticancer agents are better tolerated and more ef fective if given as continuous compared to bolus administration. Portable p ump devices are needed to allow outpatient continuous infusion. Different t ypes of portable pumps are available and we tested patient preference in a randomized crossover design. Patients and methods: Patients on continuous infusion fluorouracil were ran domly assigned to start treatment with an elastomeric infusor (Baxter) or a mechanical, electronically controlled pump (CADD-1(TM), Pharmacia) and cro ssed over to the alternative model after three weeks. After exposure to bot h pump types patients were asked to indicate their preferred device. Results: After 10 patients the study was closed because all study participa nts preferred the elastomeric pump (P < 0.01). Reasons were pump weight (10 0%), smaller pump size (89%), interference with daily activities (89%), use r friendliness (56%), impact on sleep (44%), and lack of technical problems (22%). Although the mechanical pump required more handling time for the fi rst two refillings, the learning curve suggested about equal time requireme nt thereafter. Conclusion: In the interest of patient comfort, the disposable elastomeric infusor is an acceptable alternative to the more accurate electronically co ntrolled pumps especially for drugs with a short half-life and a favorable toxicity profile.