Bénédicte Mittaine-Marzac1,2, Emmanuel Bagaragaza3,4, Joël Ankri3,5, Philippe Aegerter3, Matthieu De Stampa6,3. 1. Hospitalization At Home - Assistance Publique des Hôpitaux de Paris, 14, rue Vésale, 75005, Paris, France. benedicte.mittaine-marzac@aphp.fr. 2. CESP - Centre de recherche en Epidémiologie et Santé des Populations, U1018 INSERM UPS Université Paris-Saclay, UVSQ, Hôpital Paul Brousse 16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex Université Versailles St-Quentin, Paris, France. benedicte.mittaine-marzac@aphp.fr. 3. CESP - Centre de recherche en Epidémiologie et Santé des Populations, U1018 INSERM UPS Université Paris-Saclay, UVSQ, Hôpital Paul Brousse 16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex Université Versailles St-Quentin, Paris, France. 4. Pôle Recherche SPES « Soins Palliatifs En Société », Maison Médicale Jeanne Garnier, 106, Avenue Emile Zola, 75015, Paris, France. 5. Hôpital Sainte Périne, Assistance Publique Hôpitaux de Paris, 11 Rue Chardon Lagache, 75016, Paris, France. 6. Hospitalization At Home - Assistance Publique des Hôpitaux de Paris, 14, rue Vésale, 75005, Paris, France.
Abstract
BACKGROUND: As hospital-based home care is a complex intervention, we critically appraised the key elements that could ensure the completeness of assessment and explain the heterogeneity of the literature results about the comparison between home and hospital setting for the anticancer drugs injection within the same standards of clinical care. METHODS: Systematic review was conducted. Medline, Embase, Cochrane Library, Web of Sciences, and Cumulative Index of Nursing and Allied Health (Cinahl) searched to February 1, 2019, and combined with grey literature. Methodological quality has been rated using the "Quality Assessment Tool for Quantitative Studies" developed by the Effective Public Health Practice Project (EPHHP) in addition to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement for economic studies and the consolidated criteria for reporting qualitative research (COREQ) checklist for qualitative studies. RESULTS: Of 400 records identified, we identified 13 relevant studies (nine quantitative and four mixed-method studies). The quality of studies was hardly strong. The home-based anticancer injection involved highly heterogeneous home care interventions that generally kept a strong link with the hospital setting. The study schemes limited the comparison of clinical outcomes (OS, PFS, toxicity). Unlike the quality of life remaining similar, patients preferred to be treated at home. Cost savings were in favor of Hospital at Home, but the charge categories used to compare or the home intervention were heterogeneous and rarely integrating relatives' duties and hospital staff's time. Qualitative studies highlighted about benefits and barriers of home. CONCLUSION: The current state of evidence shows as it still remains difficult to appraise the anticancer injection at home when considering the details of this complex intervention, the role of each stakeholder, and the missing data.
BACKGROUND: As hospital-based home care is a complex intervention, we critically appraised the key elements that could ensure the completeness of assessment and explain the heterogeneity of the literature results about the comparison between home and hospital setting for the anticancer drugs injection within the same standards of clinical care. METHODS: Systematic review was conducted. Medline, Embase, Cochrane Library, Web of Sciences, and Cumulative Index of Nursing and Allied Health (Cinahl) searched to February 1, 2019, and combined with grey literature. Methodological quality has been rated using the "Quality Assessment Tool for Quantitative Studies" developed by the Effective Public Health Practice Project (EPHHP) in addition to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement for economic studies and the consolidated criteria for reporting qualitative research (COREQ) checklist for qualitative studies. RESULTS: Of 400 records identified, we identified 13 relevant studies (nine quantitative and four mixed-method studies). The quality of studies was hardly strong. The home-based anticancer injection involved highly heterogeneous home care interventions that generally kept a strong link with the hospital setting. The study schemes limited the comparison of clinical outcomes (OS, PFS, toxicity). Unlike the quality of life remaining similar, patients preferred to be treated at home. Cost savings were in favor of Hospital at Home, but the charge categories used to compare or the home intervention were heterogeneous and rarely integrating relatives' duties and hospital staff's time. Qualitative studies highlighted about benefits and barriers of home. CONCLUSION: The current state of evidence shows as it still remains difficult to appraise the anticancer injection at home when considering the details of this complex intervention, the role of each stakeholder, and the missing data.
Entities:
Keywords:
Anticancer; Health economics; Hospital At Home; Organization of health services; Public health
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