Patients', family caregivers', and professionals' perspectives on the quality of cancer drug injections at home: A qualitative and comparative study in France.

PURPOSE: While most patients on cancer treatment receive their injection in a conventional hospital setting, Hospital At Home (HAH) is an alternative solution. This research aims to describe the management of care involving HAH, highlight the expectations and needs of each stakeholder, and identify the key elements of home cancer care compared to the conventional hospital setting.

METHODS

Qualitative, prospective, and exploratory study between patients with active multiple myeloma treated exclusively in a day hospital setting versus patients alternating between a day hospital and HAH. It was based on semi-structured interviews conducted in several hospitals, in the community, and at home with patients, informal caregivers, and healthcare professionals. Grounded Theory was used for analysis.

RESULTS

Five main dimensions of management of care emerged from the 35 interviews: (i) the hospital decided on patient care regardless of location, (ii) cancer care excluded general practitioners but the HAH intervention improved their involvement, (iii) strong collaboration required between HAH and the hospital for quality and safety of care, (iv) HAH, a way to stay at home but with a complex organization (v) the profile of patients potentially eligible for home cancer injection.

CONCLUSION

Our study highlights the benefits and drawbacks of home-based care delivery from the perspective of patients with multiple myeloma, informal caregivers, and healthcare professionals. To promote home-based cancer injections, primary care services should be strengthened in relation to hospitals to achieve an optimal logistical organization for home delivery of care, and to better identify patients eligible for transfer to HAHs.