Table 2 Basic home assessment questionnaire for considering outpatient radioiodine therapy

• Does the patient have responsibilites for the care of others, especially infants and children?

• Can someone other than the patient prepare meals for the first two days?

• Can the patient's bed be adequately separated from others?

• Is it possible to designate one bathroom exclusively for the patient's use during the designated period?

• Does the patient experience stress incontinence?

• Are there circumstances in the workplace where others might receive an exposure of >1mSv from the patient?

patient needs without undue exposure of the staff if attention is paid to the time-distance rule and to the minimization of contamination.

The administration of a large therapy dose is not in itself an indication for admission to hospital. In-hospital therapy may be necessary for a patient who requires concurrent medical care, comes from a long distance by public transportation or is unable to comply with instructions. The patient must be admitted to a single room with a non-absorbent floor covering and equipped with a private shower and toilet. If the facility is not designed for radiopharmaceutical therapy, then care must be taken to avoid exposure of patients in adjacent rooms. Adult visitors should be restricted to brief visits (15-30 minutes). It is important that patients not be made to feel that they are "locked up": the door to the room may be open, the room should be cleaned as needed and staff should not feel so pressed to leave the room as to have no time for social interaction with the patient.

Discharge may occur when the patient no longer needs concurrent medical care and when it can be reasonably assumed that no member of the public will receive a dose in excess of the public limit from the patient.

In many countries there are national advisory committees that have developed useful documents to promote quality assurance and safety in radionuclide therapies. These are often up to date and should be consulted in the preparation of a local therapy protocol.

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