Treatment for multiple myeloma in hospital at home: clinical characteristics and patient care pathways

Home Health Care Serv Q. 2022 Apr-Jun;41(2):165-181. doi: 10.1080/01621424.2021.2023063. Epub 2022 Jan 3.

Abstract

While most patients receive anticancer injection in a conventional hospital, some are treated in hospital at home. Given the lack of data, we seek to determine the clinical characteristics and care pathways of patients benefiting from hospital at home (HAH) for anticancer injection. A longitudinal scheme was conducted about patients with multiple myeloma (MM) starting bortezomib-based regimens in HAH in 2015 with a follow-up to September 2019. 154 patients received bortezomib at home with a mean age of 70.6 years, 72.7% over 65y-old and, a median Karnofsky Performans Status of 70. One-third of the elderly lived alone, 16.1% required domestic help. After a 24-month follow-up, 77.9% of patients were alive. The median overall survival was not reached at 4 years. Between 42.1% and 48.1% of patients returned to HAH for a new line of treatment. Patients were mainly independent and "fit." The involvement of HAH was achieved without safety issues nor compromise long-term outcomes. However, the real-world patterns highlighted that only a small proportion of patients returned to HAH for a new treatment line.

Keywords: Hospital at home; anticancer; multiple myeloma.

MeSH terms

  • Aged
  • Bortezomib / therapeutic use
  • Critical Pathways
  • Hospitals
  • Humans
  • Multiple Myeloma* / drug therapy
  • Patient Care

Substances

  • Bortezomib