Hospital-based home care can work for children with cancer

Jan 22 2013

By Helen Albert, Senior medwireNews Reporter

Hospital-based home care (HBHC) is a feasible alternative for children with cancer both regarding price and efficacy, show study findings.

The researchers particularly note that home-based treated was greatly preferred by parents and that the health-related quality of life (HRQoL) of the children also appeared to improve in those treated at home compared with in hospital.

Helena Hansson (Copenhagen University Hospital, Denmark) and colleagues carried out a HBHC study to assess the viability of moving cancer care to the home environment for 51 children, aged 0-18 years, with a variety of cancer types.

They found that all the patients in the study preferred home care and were satisfied with their treatment. There were no serious adverse events linked to being at home and costs of treatment were similar to those accrued in the hospital environment.

Following the initial feasibility study, the investigators recruited 28 children and 43 parents to form the HBHC care arm and 47 children and 66 parents to form the hospital care arm of a comparison study of the efficacy of the two treatment locations.

For most factors, the two groups did not have significantly different outcomes, but parent reported physical health and worry were significantly improved in the HBHC group compared with that of the hospital-based controls when the researchers adjusted for gender, age, diagnosis, and time since diagnosis.

The team recognizes the limitations of this study as the groups included a wide range of ages and diagnoses, and factors such as number of home visits, parental education, and distance from the hospital may have influenced the results.

However, "HBHC seems an appropriate and acceptable way of providing care," write Hansson and colleagues in Pediatric Blood and Cancer.

"The study highlights the importance of further studies routinely measuring HRQoL combined with health outcomes to be able to assess the psychosocial impact of HBHC over time," they conclude.

"Future research should also address economic evaluations that include both actual and indirect cost."

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