A multi-method review of home-based chemotherapy

Abstract

This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes.

Safety and Family Satisfaction of a Home-Delivered Chemotherapy Program for Children with Cancer

“…Besides, the staff did not experience any safety issues. This nding highlights the safety of an established protocol for chemotherapy transport, storage, administration and disposal and underlines the need for speci c training for nurses and clinicians 4,7 . These data are in line with other studies aimed at exploring the safety of home intravenous therapy programs for both adult and pediatric patients with cancer.…”

Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data

“…This is due in part to the increasing number of older cancer patients being treated in the community (Evans et al, 2016;Kenyon et al, 2014). This is due in part to the increasing number of older cancer patients being treated in the community (Evans et al, 2016;Kenyon et al, 2014).…”

“…Stronger involvement of GPs in cancer care is necessary. This is due in part to the increasing number of older cancer patients being treated in the community (Evans et al, 2016;Kenyon et al, 2014). GPs' involvement can facilitate continuity of care and studies indicate that both GPs and cancer patients endorse an enhancement of GPs' role in cancer care (Anvik et al, 2006;Del Giudice, Grunfeld, Harvey, Piliotis, & Verma, 2009;Halkett, Jiwa, & Lobb, 2015).…”

“…While cancer care has shifted towards a multidisciplinary model, a growing number of patients who have or have had cancer are treated in the community setting (Evans et al, 2016;Kenyon, Mayer, & Owens, 2014). This is due to a shift in treatment approaches that have become more tolerable and can therefore be administered in outpatient settings (Evans et al, 2016) and to more efficient therapies, which lead to a growing demand for follow-up care (Kenyon et al, 2014). Specialists treat cancer patients in acute phases, providing tumour-specific therapies as well as palliative care (Cherny, 2010;Popescu et al, 2014).…”

Bridging silos: Delivering integrated care to patients with cancer in Ontario, Canada

“…Second, the quality of cancer care delivered within the walls of RCPs was consistently improving, but provincial quality improvement efforts rarely extended beyond hospitals . Third, evidence was accumulating that aspects of cancer care could be safely and effectively delivered in the community and patients' homes . Finally, tackling a system‐wide goal like integrating care aligned with CCO's disease‐agnostic vision to “create the best health systems in the world” and the agency's unique mandate spanning funding, planning, managing, and improving both cancer and renal care.…”