Research suggests that symptom monitoring interventions and hospital-in-the-home care models can improve outcomes for patients with serious illness, but prior studies have not investigated these interventions for patients receiving treatment of pancreatic cancer. A key objective of symptom monitoring interventions and hospital-in-the-home care models is that patients are closely monitored to ensure that concerning issues can be addressed efficiently and effectively in order to prevent the need for urgent visits and/or hospitalizations.
“We know that patients with pancreatic cancer receiving chemotherapy represent a highly symptomatic population for whom interventions involving symptom monitoring and hospital-in-the-home care have potential to benefit patients and prevent excess health care utilization,” says the lead investigator Ryan Nipp, MD, a medical oncologist at Mass General Cancer Center.
To determine the feasibility of delivering a Supportive Oncology Care at Home intervention designed to address the needs of patients receiving treatment for pancreatic cancer, Ryan Nipp, MD, of Mass General Cancer Center, and his colleagues collaborated with Medically Home, a Boston-based high-acuity hospital at home platform to address the needs of these patients at home. The investigators prospectively enrolled patients with pancreatic cancer who were participating in a parent trial of neoadjuvant chemotherapy. In their study, the researchers enrolled 20 patients to receive the Supportive Oncology Care at Home intervention during their treatment. The intervention entailed: (1) remote monitoring of daily patient-reported symptoms, daily vital signs, and weekly body weight; (2) a hospital-in-the-home care model for symptom assessment and management; and (3) structured communication with the oncology team.
This study met its primary endpoint of demonstrating feasibility. Specifically, over 80% of patients approached for the study agreed to enroll. Additionally, over 60% of participants completed all their daily symptom assessments. The authors found high acceptability for the Supportive Oncology Care at Home intervention, with over 80% of patients, caregivers, and clinicians reporting that the intervention was helpful and convenient. Participants also reported high satisfaction with the communication among patients, clinicians, and the hospital-in-the-home team.
Notably, patients receiving the Supportive Oncology Care at Home intervention experienced lower rates of treatment delays, urgent clinic visits, emergency room visits or hospitalizations, as well as a lower proportion of days spent in urgent clinic, emergency room, or hospital, compared with those not receiving the intervention. Although further study is required, these early data suggest that using the home hospital platform in this way allowed patients to experience fewer days in an urgent clinic, emergency room, or hospital setting.
“This work demonstrates the feasibility and acceptability of delivering Supportive Oncology Care at home for patients with cancer. Additionally, these findings highlight the need for future work to further investigate the efficacy of this intervention for decreasing healthcare use and improving patient outcomes,” said Nipp.
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