Evans J M, Qiu M, MacKinnon M, Green E, Peterson K, Kaizer L
Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.
Integrated Care Unit, Cancer Care Ontario, Toronto, ON, Canada.
Eur J Cancer Care (Engl). 2016 Sep;25(5):883-902. doi: 10.1111/ecc.12408. Epub 2015 Nov 6.
This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes.
本研究总结了基于研究和实践的居家化疗证据，并探讨了现有的服务模式。开展了一项三管齐下的调查，包括对54篇论文进行文献综述和综合分析、对四个国家的七个居家化疗项目进行审查，以及在加拿大安大略省进行两个案例研究。结果支持将居家化疗作为一种安全且以患者为中心的替代方案，以取代基于医院和门诊的服务。本文整合了有关居家化疗项目的信息，包括提供的服务和药物、患者资格标准、患者观点和体验、服务提供结构和流程以及常见挑战。还提出了十四项建议，通过优先考虑以患者为中心、提供者培训和团队合作、护理安全和质量以及项目管理，来改善患者家中化疗的提供。本研究结果可用于为制定一个基于证据的模式提供信息，以便在患者家中提供化疗及相关护理，如症状管理。
