Key takeaways:
- An at-home intervention didn’t cut back inpatient hospital admissions or ED visits vs. normal care.
- Sufferers assigned the intervention required fewer pressing clinic visits and reported improved symptom burden.
CHICAGO — An intervention designed to offer supportive oncology care at house could improve care supply and enhance outcomes for folks receiving healing most cancers remedy, based on findings offered at ASCO Annual Assembly.
Outcomes confirmed no distinction in inpatient hospital admission fee or ED visits — the research’s major final result — between sufferers assigned the intervention vs. normal care.
Information derived from Nipp RD, et al. Summary 11003. Introduced at: ASCO Annual Assembly; Could 30-June 3, 2025; Chicago.
Nevertheless, fewer sufferers assigned the intervention required pressing clinic visits. In addition they skilled “substantial enchancment” in symptom burden and actions of every day residing, Ryan Nipp, MD, MPH, gastrointestinal oncologist and most cancers outcomes researcher at OU Well being Stephenson Most cancers Heart, and colleagues concluded.
Individuals with most cancers present process healing remedy typically expertise appreciable symptom burdens. Widespread signs embrace fatigue, nausea, ache, and despair and anxiousness.
“A affected person’s symptom burden and remedy uncomfortable side effects contribute to excessive well being care utilization, impaired useful standing and worse high quality of life,” Nipp mentioned throughout a presentation. “Symptom monitoring interventions and hospital-at-home care fashions symbolize promising approaches for bettering affected person outcomes.”
Nipp and colleagues carried out a randomized managed trial to check a supportive oncology care at house intervention vs. normal take care of adults receiving curative-intent most cancers remedy.
The cohort included 196 sufferers who lived inside 50 miles of Massachusetts Common Hospital.
All sufferers had been receiving chemotherapy and/or chemoradiation for certainly one of 5 most cancers sorts: pancreatic most cancers (34.2%), head and neck most cancers (27%), non-Hodgkin lymphoma (16.3%), rectal most cancers (12.8%) or gastroesophageal most cancers (9.7%). All sufferers had began curative-intent remedy inside the prior 2 weeks.
Researchers randomly assigned sufferers to the at-home intervention (n = 98) or normal care (n = 98) for as much as 6 months. Teams appeared balanced for median age (62.1 years vs. 63.8 years), feminine intercourse (41% vs. 39%), white race (87% vs. 93%) and different traits.
The at-home intervention included every day distant monitoring for patient-reported signs, physique weight and important indicators; a hospital-at-home care mannequin for symptom evaluation and administration; and structured communication with the oncology group. Algorithms decided when sufferers wanted to be contacted by telephone or visited at their house. Communication with the oncology group included a abstract e-mail prior to every chemotherapy cycle, in addition to an e-mail summarizing telephone calls or house visits inside 24 hours.
The proportion of sufferers who required inpatient hospital admission or ED visits throughout the research interval served as the first final result.
Pressing visits to the clinic and remedy delays served as secondary outcomes. Researchers additionally assessed modifications in month-to-month assessments for signs, anxiousness and despair, and high quality of life, in addition to actions of every day residing.
Outcomes confirmed no vital distinction in charges of hospital admission or ED visits (37.1% vs. 35.7%) or share of sufferers with remedy delays longer than 7 days (29.9% vs. 33%) between the intervention and normal care teams.
Nevertheless, a considerably decrease share of sufferers assigned the intervention required an pressing clinic go to (7.2% vs. 24.5%; OR = 0.22; P = .001).
Examine members assigned the intervention additionally had larger enchancment over time in scores on the Edmonton Symptom Evaluation System (P < .001) and actions of every day residing (P = .04).
Outcomes confirmed no variations in high quality of life or despair/anxiousness signs as assessed by the Hospital Anxiousness and Melancholy Scale.
Researchers acknowledged research limitations, together with the single-center design and restricted range of the cohort.
“Extra work is required to additional perceive potential moderators and mediators,” Nipp mentioned. “Are there variations primarily based on the totally different most cancers sorts we included or doubtlessly differential impacts primarily based on age? It additionally could be attention-grabbing to see if the variations we noticed in useful standing are pushed by the concept that we improved sufferers’ signs over time. We additionally assume further research are wanted the cost-effectiveness of a lot of these fashions.”
Sources/Disclosures
Collapse
Nipp RD, et al. Summary 11003. Introduced at: ASCO Annual Assembly; Could 30-June 3, 2025; Chicago.
Disclosures:
Nipp studies no related monetary disclosures. Please see the research for all authors’ related monetary disclosures.
