Early discharge after high dose chemotherapy is safe and feasible: a prospective evaluation of 6 years of home care

Abstract

A single-center, prospective, non-randomized clinical study was performed to examine the safety and feasibility of early discharge in patients undergoing consolidation chemotherapy for acute leukemia, or autologous stem cell transplant for lymphoma or multiple myeloma. Patients were discharged into ambulatory care the day after the last chemotherapy administration and were subsequently seen at the ambulatory care unit three times a week. One hundred and one of 224 patients were ineligible for the program, mostly because of their medical situation, the lack of a caregiver or the travel time to the hospital. The remaining 123 patients were able to spend more than 70% of the time at home. In 44% of cycles they were never readmitted. This study demonstrates the safety, feasibility and benefits of managing carefully selected patients. Patients and their caregivers felt safe and comfortable at home, and the vast majority preferred home care to in-hospital treatment.

Keywords::

• Infectious complications
• clinical results
• chemotherapeutic approaches
• ambulatory care
• nursing

Acknowledgements

The authors would like to thank the patients and caregivers who participated in this study, and the nurses and doctors who cared for the patients. Bart Biemond, hematologist, is acknowledged for critically reading the manuscript. Hans van der Lelie, former staff member of the Department of Hematology at the Academic Medical Center, is acknowledged for his strong belief in this project and for providing the basis for ambulatory care at our hospital.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.