A randomized controlled trial examined the use of oncologic home hospitalization (OHH) in comparison with standard ambulatory cancer care (SOC), and results suggested that OHH may provide high-quality care for many patients with cancer in a patient-centered manner. The study findings were published in JCO Global Oncology.
This study was based at a hospital in Kortrijk, Belgium. In this study, OHH involved the administration of some cancer treatments subcutaneously, as well as home nursing assessments prior to ambulatory systemic cancer treatment. Full OHH involved complete replacement of hospital visits with home visits, and partial OHH involved the combination of home nursing assessments and in-hospital therapy administration.
The study follow-up period was 12 weeks, and the primary endpoint was patient-reported quality of life (QOL). This was based on the functional assessment of cancer therapy questionnaire (FACT-G, v4). Other endpoints involved multiple methods for assessing QOL and similar outcomes.
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Each trial arm consisted of 74 patients. OHH and SOC showed equivalence in patient-reported QOL outcomes. The mean number of oncology day care unit visits with full OHH was 5.6±3.0, compared with a higher count with SOC (13.2±4.6; P =.011).
Partial OHH care at times resulted in cancelation of a next-day day care unit appointment because information was obtained during the home visit. Partial OHH also was associated with shortened waiting times for administration of treatment at the day care unit; the mean waiting time was 2 hours and 36 minutes ± 1 hour and 4 minutes for patients receiving partial OHH, compared with 4 hours ± 1 hour and 4 minutes for the SOC group (P <.001).
A high degree of satisfaction with OHH was reported in 88% of respondents who received OHH as a means of care. A positive impact on QOL was also reported by 77% of respondents who received OHH. Across the total study population, including both arms, 60% of patients reported a preference for OHH over SOC. For continuation of treatment, a total of 16 patients chose OHH care after completing the 12 weeks of study in the SOC arm.
The researchers did not find adverse events associated with OHH, based on reporting by coordinating nurses. In the OHH arm, 48 patients expressed feeling as safe at home as in the oncology day care unit, 7 reported feeling safer at home, and 1 patient felt safer at the day care unit.
“In conclusion, given the increasing number of patients with cancer in need of systemic treatment and the evolution toward safer treatment options, (partial) oncologic home hospitalization offers a high-quality and patient-centered alternative to the current ambulatory cancer care for a large proportion of patients with cancer,” the researchers concluded in their report.
Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Reference
Cool L, Missiaen J, Debruyne P, et al. Oncologic home-hospitalization delivers a high-quality and patient-centered alternative to standard ambulatory care: results of a randomized-controlled equivalence trial. JCO Glob Oncol. 2021;7:1564-1571. doi:10.1200/GO.21.00158
