Objectives To determine patient preferences and cost differences between home‐based and hospital‐based chemotherapy. Design Randomised crossover trial. Setting A tertiary cancer hospital in Melbourne, Victoria. Participants 20 patients who required chemotherapy suitable for administration at home. Interventions Patients were assigned at random to receive their first chemotherapy treatment in either the home or the hospital and the second treatment in the alternative setting. Main outcome measures Patient preference, costs. Results There was universal agreement by the 20 patients in the randomised trial that home‐based chemotherapy was the preferred option (P< 0.0001). No problems were nominated by the patients as being associated with home‐based chemotherapy. Home‐based treatment was estimated to result in an increased cost of $83 (P=0.0002) for each chemotherapy treatment compared with hospital‐based treatment. Reported advantages for chemotherapy in the home included the elimination of travel, reduction in treatment‐associated anxiety, reduction in the burden on carers and family, and the ability to continue other duties. There were no significant complications associated with administration of chemotherapy in the home. Conclusions Patients prefer home‐based chemotherapy to hospital‐based treatment. The future of chemotherapy‐in‐the‐home programs in Australia will depend on whether patient preferences are deemed to offset any potential increase in costs.

The impact on 100 patients of information and consent forms signed prior to medical oncology clinical trials was evaluated by a survey at a subsequent visit. Only 40 patients believed that the purpose of the form was to explain the treatment. The form was listed as the major source of information by 12 patients while 52 listed a doctor and 26 a nurse. Although 21 patients believed that the form mad them less anxious, 19 patients believed that it made them more anxious. Despite 80 patients reading all of the form, 60 claiming to understand all of it and 68 claiming that in contained adequate information, in tests of recall only 52 patients could name all of their drugs and only 4 all of the side effects. The number of drugs named correlated with how much of the consent form had been read (p = 0.003) and the highest education level achieved by the patient (p = 0.0003). Patients under 55 years had significantly better recall. Patients with a better ECOG performance status were more likely to find the form very helpful. Such forms may not ensure that the requirements for informed consent are satisfied.

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