Port REMoval Outcomes (PREMO) study: Patients' experiences with a Totally Implantable Venous Access Device: A questionnaire at device removal.

Abstract

Background: Totally Implantable Venous Access Devices (TIVADs) are commonly used for intravenous chemotherapy administration and may remain in place depending on the likelihood of disease relapse. Regular flushing is required to maintain patency, although there is no established consensus on the optimal interval between maintenance sessions, with some clinicians extending or omitting the procedure. While TIVADs are generally well-accepted, patients may experience physical discomfort or psychological stress, which are assessed through Patient Reported Outcomes (PROs). This study aims to evaluate the complete TIVAD experience, from insertion to removal, with a particular focus on the maintenance period, as part of the Port REMoval Outcomes (PREMO) study.

Methods: A cross-sectional survey was conducted at University Hospitals Leuven, Belgium between 2019 and 2022. Adult patients with chest TIVADs, planned for an elective removal, completed the Leuven Patient Reported Experiences at Port Removal (Leuven PREP) a self-reported, self-developed 27-item questionnaire.

Results: A total of 100 oncology patients completed the questionnaire, with a mean age of 60.9 years and a median TIVAD duration of 2093 days. Most patients reported low insertion pain (median NRS score = 2), while emotional and psychological impacts were generally minimal, with only 1% expressing constant fear. Local discomfort was mentioned, with 24.5% reporting a bump and 12% experiencing pain during needle insertion; 10% experienced frequent cosmetic issues. TIVAD maintenance adherence was limited to 70.7% following the flushing regimen, and 61.2% found extending the maintenance period valuable. The removal procedure was well-received, with 60.2% reporting it was better than expected, and overall patient satisfaction was high, with a median score of 8/10.

Conclusion: Patients expressed high satisfaction with low impact on comfort, psychological state and physical well-being. Maintenance experiences varied, highlighting the need for further investigation and a validated comprehensive questionnaire.

Registration number: NCT03948958.