Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial
PURPOSEGiven the increasing burden of cancer on patients, health care providers, and payers, the shift of certain outpatient procedures to the patients' homes (further indicated as oncologic home-hospitalization [OHH]) might be a high-quality, patient-centered, and cost-effective alternative to...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2021-12-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.21.00158 |
| _version_ | 1818356608215810048 |
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| author | Lieselot Cool Jana Missiaen Philip Debruyne Hans Pottel Veerle Foulon Tessa Lefebvre Laura Tack Petra Archie Dominique Vandijck Koen Van Eygen |
| author_facet | Lieselot Cool Jana Missiaen Philip Debruyne Hans Pottel Veerle Foulon Tessa Lefebvre Laura Tack Petra Archie Dominique Vandijck Koen Van Eygen |
| author_sort | Lieselot Cool |
| collection | DOAJ |
| description | PURPOSEGiven the increasing burden of cancer on patients, health care providers, and payers, the shift of certain outpatient procedures to the patients' homes (further indicated as oncologic home-hospitalization [OHH]) might be a high-quality, patient-centered, and cost-effective alternative to standard ambulatory cancer care (SOC).METHODSA randomized-controlled trial was conducted to evaluate the quality of a locally implemented model for OHH (n = 74) compared with SOC (n = 74). The model for OHH consisted of home administration of certain subcutaneous cancer drugs (full OHH) and home nursing assessments before ambulatory systemic cancer therapy (partial OHH). Quality was evaluated based on patient-reported quality of life (QoL) and related end points; service use and cost data; safety data; patient-reported satisfaction and preferences; and model efficiency. An equivalence design was used for primary end point analysis. Participants were followed during 12 weeks of systemic cancer treatment.RESULTSThis trial demonstrated equivalence of both models (OHH v SOC) in terms of patient-reported QoL (95% CI not exceeding the equivalence margin of 10%). Full OHH resulted in significantly less hospital visits (mean of 5.6 ± 3.0 v 13.2 ± 4.6; P = .011). Partial OHH reduced waiting times for therapy administration at the day care unit with 45% per visit (2 hours 36 minutes ± 1 hour 4 minutes v 4 hours ± 1 hour 4 minutes; P < .001). No safety issues were detected. Of the intervention group, 88% reported to be highly satisfied with the OHH model, and 77% reported a positive impact on their QoL. At study end, 60% of both study arms preferred OHH above SOC.CONCLUSIONThe shift of particular procedures from the outpatient clinic to the patients' homes offers a high-quality and patient-centered alternative for a large proportion of patients with cancer. Further research is needed to evaluate potential cost-efficiency. |
| first_indexed | 2024-12-13T19:59:55Z |
| format | Article |
| id | doaj.art-d337389066864434bf85603e940ecd1a |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-12-13T19:59:55Z |
| publishDate | 2021-12-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-d337389066864434bf85603e940ecd1a2022-12-21T23:33:13ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412021-12-0171564157110.1200/GO.21.00158Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence TrialLieselot Cool0Jana Missiaen1Philip Debruyne2Hans Pottel3Veerle Foulon4Tessa Lefebvre5Laura Tack6Petra Archie7Dominique Vandijck8Koen Van Eygen9Cancer Centre, General Hospital Groeninge, Kortrijk, BelgiumCancer Centre, General Hospital Groeninge, Kortrijk, BelgiumCancer Centre, General Hospital Groeninge, Kortrijk, BelgiumDepartment of Public Health and Primary Care @ Kulak, Catholic University Leuven Kulak Etienne Sabbelaan, Kortrijk, BelgiumDepartment of Pharmaceutical and Pharmacological Sciences, Catholic University Leuven, Leuven, BelgiumCancer Centre, General Hospital Groeninge, Kortrijk, BelgiumCancer Centre, General Hospital Groeninge, Kortrijk, BelgiumCancer Centre, General Hospital Groeninge, Kortrijk, BelgiumFaculty of Medicine and Health Sciences, Ghent University, Gent, BelgiumCancer Centre, General Hospital Groeninge, Kortrijk, BelgiumPURPOSEGiven the increasing burden of cancer on patients, health care providers, and payers, the shift of certain outpatient procedures to the patients' homes (further indicated as oncologic home-hospitalization [OHH]) might be a high-quality, patient-centered, and cost-effective alternative to standard ambulatory cancer care (SOC).METHODSA randomized-controlled trial was conducted to evaluate the quality of a locally implemented model for OHH (n = 74) compared with SOC (n = 74). The model for OHH consisted of home administration of certain subcutaneous cancer drugs (full OHH) and home nursing assessments before ambulatory systemic cancer therapy (partial OHH). Quality was evaluated based on patient-reported quality of life (QoL) and related end points; service use and cost data; safety data; patient-reported satisfaction and preferences; and model efficiency. An equivalence design was used for primary end point analysis. Participants were followed during 12 weeks of systemic cancer treatment.RESULTSThis trial demonstrated equivalence of both models (OHH v SOC) in terms of patient-reported QoL (95% CI not exceeding the equivalence margin of 10%). Full OHH resulted in significantly less hospital visits (mean of 5.6 ± 3.0 v 13.2 ± 4.6; P = .011). Partial OHH reduced waiting times for therapy administration at the day care unit with 45% per visit (2 hours 36 minutes ± 1 hour 4 minutes v 4 hours ± 1 hour 4 minutes; P < .001). No safety issues were detected. Of the intervention group, 88% reported to be highly satisfied with the OHH model, and 77% reported a positive impact on their QoL. At study end, 60% of both study arms preferred OHH above SOC.CONCLUSIONThe shift of particular procedures from the outpatient clinic to the patients' homes offers a high-quality and patient-centered alternative for a large proportion of patients with cancer. Further research is needed to evaluate potential cost-efficiency.https://ascopubs.org/doi/10.1200/GO.21.00158 |
| spellingShingle | Lieselot Cool Jana Missiaen Philip Debruyne Hans Pottel Veerle Foulon Tessa Lefebvre Laura Tack Petra Archie Dominique Vandijck Koen Van Eygen Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial JCO Global Oncology |
| title | Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial |
| title_full | Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial |
| title_fullStr | Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial |
| title_full_unstemmed | Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial |
| title_short | Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial |
| title_sort | oncologic home hospitalization delivers a high quality and patient centered alternative to standard ambulatory care results of a randomized controlled equivalence trial |
| url | https://ascopubs.org/doi/10.1200/GO.21.00158 |
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