This study compared a hospital-based chemotherapy delivery model and a home-based chemotherapy program by following 11 children, aged 2 to 16, with acute lymphoblastic leukemia (ALL). Treatment for ALL usually includes repetitive cycles of chemotherapy in hospital for a period of three years. The study’s main goal was to see whether the quality of life for children and families was improved with home delivery without increasing adverse events, caregiver burden, or emotional stress. Cost-effectiveness and the acceptance of the service by families and health care staff was also evaluated. While noting that 11 children is too small a sample size to demonstrate significance, the study found that results of qualitative interviews found improvements in quality of life for both children and families with the home treatment and that home chemotherapy would appear to be safe and feasible. There was no difference in the nature and frequency of adverse events between home and hospital. Health care workers were generally supportive but were concerned about safety, accountability, qualified staffing, and ensuring that the home is still considered a “safe place” for the child with cancer when the home is also the locus of treatment.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.