Home-based treatment for multiple myeloma patients: early insights from a pilot project
Saskia Claassen, Damien S E Broekharst, Eline J Mertens, Sjaak Bloem, Nathascha Hanzen, Karla de Rooij, Nicole de Graauw, Maartje van der Klooster, Lonneke Suijkerbuijk, Heleen Vroman, Mariët RaatgeverBackground/aims
The increasing prevalence of cancer is exerting mounting pressure on hospital infrastructure. To help to address this challenge, a hospital and home care organisation in the Netherlands collaborated on a pilot project in which patients with multiple myeloma received treatment in home-based settings. This study aimed to evaluate this pilot project, looking at its impact on patient outcomes such as frailty and satisfaction.
Methods
Data were collected on patients with multiple myeloma who were enrolled in the pilot, both at baseline and after they had received 3 months of home-based care. Frailty was assessed using the G8 questionnaire. Disease control and acceptance were assessed using the Subjective Health Experience (SHE) questionnaire, to determine patients' need for psychosocial care. At follow up, patients were asked to score their satisfaction with home-based care, hospital-based care and the evaluation measures used. Data were analysed and reported using percentual distributions, means, standard deviations, paired t -test statistics and variance analysis. Statistical significance was set at P <0.05
Results
A total of 41 patients participated in the pilot, of whom 30 provided data for analysis. Frailty scores reduced significantly between baseline and follow up, and modest improvements in disease control and acceptance scores were also observed. Participants reported high levels of satisfaction with their care, with slightly higher scores given for home-based than hospital-based care. They were also fairly satisfied with the measurement instruments. Of the 29 participants offered psychosocial care, only three accepted it.
Conclusions
This study suggests that home-based treatment for multiple myeloma can lead to positive outcomes, including reduced frailty, improved disease control and acceptance and high patient satisfaction.
Implications for practice
The outcomes of this pilot project can provide useful learning for oncology services looking to implement home-based care, particularly in collaboration with a home care or community service. Further research should consider comparison with hospital-based care outcomes and exploration of psychosocial support delivery, potentially using SHE stratification.