Hospitalization At Home - Assistance Publique des Hôpitaux de Paris, 14, rue Vésale, 75005, Paris, France.
CESP - Centre de recherche en Epidémiologie et Santé des Populations, U1018 INSERM UPS Université Paris-Saclay, UVSQ, Hôpital Paul Brousse 16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex Université Versailles St-Quentin, Paris, France.
Support Care Cancer. 2021 Oct;29(10):5581-5596. doi: 10.1007/s00520-021-06145-5. Epub 2021 Mar 25.
As hospital-based home care is a complex intervention, we critically appraised the key elements that could ensure the completeness of assessment and explain the heterogeneity of the literature results about the comparison between home and hospital setting for the anticancer drugs injection within the same standards of clinical care.
Systematic review was conducted. Medline, Embase, Cochrane Library, Web of Sciences, and Cumulative Index of Nursing and Allied Health (Cinahl) searched to February 1, 2019, and combined with grey literature. Methodological quality has been rated using the "Quality Assessment Tool for Quantitative Studies" developed by the Effective Public Health Practice Project (EPHHP) in addition to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement for economic studies and the consolidated criteria for reporting qualitative research (COREQ) checklist for qualitative studies.
Of 400 records identified, we identified 13 relevant studies (nine quantitative and four mixed-method studies). The quality of studies was hardly strong. The home-based anticancer injection involved highly heterogeneous home care interventions that generally kept a strong link with the hospital setting. The study schemes limited the comparison of clinical outcomes (OS, PFS, toxicity). Unlike the quality of life remaining similar, patients preferred to be treated at home. Cost savings were in favor of Hospital at Home, but the charge categories used to compare or the home intervention were heterogeneous and rarely integrating relatives' duties and hospital staff's time. Qualitative studies highlighted about benefits and barriers of home.
The current state of evidence shows as it still remains difficult to appraise the anticancer injection at home when considering the details of this complex intervention, the role of each stakeholder, and the missing data.
由于医院为基础的家庭护理是一种复杂的干预措施，我们批判性地评估了确保评估完整性的关键要素，并解释了在相同临床护理标准下比较家庭和医院环境中抗癌药物注射的文献结果存在差异的原因。
系统综述。截至 2019 年 2 月 1 日，我们检索了 Medline、Embase、Cochrane 图书馆、Web of Sciences 和 Cumulative Index of Nursing and Allied Health（Cinahl），并结合了灰色文献。使用有效公共卫生实践项目（EPHHP）开发的“定量研究质量评估工具”以及经济研究的统一健康经济评估报告标准（CHEERS）声明和定性研究的统一报告标准（COREQ）清单对方法学质量进行了评估。
在 400 条记录中，我们确定了 13 项相关研究（9 项定量研究和 4 项混合方法研究）。研究质量几乎不强。家庭为基础的抗癌注射涉及高度异质的家庭护理干预措施，通常与医院环境保持密切联系。研究方案限制了临床结局（OS、PFS、毒性）的比较。与生活质量相似不同，患者更喜欢在家中接受治疗。家庭医疗保健有利于节省成本，但用于比较的费用类别或家庭干预措施存在差异，并且很少整合亲属的职责和医院工作人员的时间。定性研究强调了家庭的好处和障碍。
目前的证据状况表明，考虑到这种复杂干预措施的细节、每个利益相关者的角色和缺失的数据，仍然难以评估在家中进行抗癌药物注射的情况。
