Safety and family satisfaction of a home-delivered chemotherapy program for children with cancer

Abstract

Background Home chemotherapy programs for children with cancer are safe and feasible, and their impact on the quality of life has been reported in different countries. A home chemotherapy program was implemented between 2011 and 2019 in an Italian region. This pilot study investigates its safety and feasibility, along with parental satisfaction. Methods Patients between 0 and 18 years diagnosed with malignancy were included. Deceased patients and patients whose families moved abroad or interrupted contact with the service were excluded. Adverse events comprised immediate deterioration of the patient’s condition, equipment failure, errors in drug storage, dose or patient identification and personnel safety issues. Parental satisfaction was explored through an email survey of 32 Likert-type and short open questions. Results Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine). No adverse events were reported. Twenty-three families out of 25 eligible completed the survey. Most reported being “very satisfied” with the possibility of maintaining a work/domestic routine and reducing time and financial burden of hospital access. Most were “very satisfied” with the opportunity for their child of being less troubled by the treatment. Besides, most reported being “very satisfied” with the chance for healthy siblings of maintaining their routine and coping with their brother/sister’s disease. Most perceived the program as safe. All families recommended extending the program to all children in the region. Conclusions This first Italian study supports home chemotherapy as safe and effective, positively influencing the quality of life for children and their families.

Cancer treatment closer to the patient, reduces travel burden, time toxicity and improve patients satisfaction. Results on 546 consecutive patients in a North Italy district

“…The primary end-points of this study are the kms saved with treatment closer to patient's home and the average travel times gained with this organization evaluated calculating the distance from the residence of patients to the outpatient setting closer to their home, compared with the distance to reach the oncology unit of the referral hospital, using Google Maps. Secondary endpoints are 1) the reduction of need of caregivers to drive patients to reach the nearest outpatient setting, compared to the need of caregivers to reach the central hospital of Piacenza, 2) the rate of satisfaction with treatment nearest the residence of patients analyzed with dedicated questionnaire that used a 5 items Likert-type scale ranging from "not at all satis ed/ completely disagree" to "very satis ed/strongly agree" [14]. This questionnaire was administered after two months of treatment and at the end of the planned therapy.…”

Home-deliverable antitumoral treatments in the age of COVID-19: the Portsmouth experience and a narrative review

“…In Italy, two programs have been described in a pediatric population. One in Friuli Venezia Giulia ( 18 ), that existed before the pandemic. Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine).…”

National expert consensus on home-administered oncologic therapies in Spain

“…HaH teams are trained to perform complex interventions at home, which would reduce the hospital burden preventing the negative consequences of this overload on cancer patients (10)(11)(12)(13). Moreover, treating cancer patients at home can help to control high-risk situations such as the exposure to epidemics of multidrug-resistant pathogens or community viral infections with high morbidity and mortality (14).…”