At-Home Supportive Cancer Care for Advanced Cancer

Overseen By Ryan D Nipp, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: ICU admission, High oxygen, Angina, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 2 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program called Supportive Oncology Care at Home to determine if remote monitoring and home-based care benefit people with advanced cancer after hospital discharge. The program includes daily symptom and vital sign check-ins, home visits as needed, and communication with the cancer care team to maintain coordination. Suitable candidates have advanced cancer, recently experienced an unexpected hospital stay, and live near Massachusetts General Hospital. As an unphased trial, this study provides a unique opportunity to contribute to innovative care solutions that could improve the quality of life for cancer patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that this program is safe for patients with advanced cancer?

Research has shown that Supportive Oncology Care at Home is generally well-received by patients. Studies have found that these home-based care programs reduce the need for hospital visits and increase patient satisfaction. For example, one study found that 42.2% to 91% of patients avoided returning to the hospital, and their caregivers felt safe and satisfied with the care provided at home.

No major reports of negative effects have been directly linked to the Supportive Oncology Care at Home program. This suggests that the care model is safe for patients with advanced cancer. Regular communication with the oncology team and remote monitoring quickly address any issues, ensuring continuous and safe care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Supportive Oncology Care at Home program because it offers a unique approach to managing advanced cancer care post-hospital discharge. Unlike standard treatments that often require frequent in-person visits and hospital stays, this program provides daily monitoring of symptoms and vital signs in the comfort of the patient's home. It uses an algorithmic system to tailor care based on real-time data, ensuring personalized and responsive support. Additionally, it fosters structured communication with the oncology team, promoting seamless continuity of care. This innovative setup aims to enhance patient comfort and potentially improve outcomes by integrating healthcare into daily life.

What evidence suggests that the Supportive Oncology Care at Home program is effective for advanced cancer care?

Studies have shown that receiving care at home can improve the quality of life for patients with advanced cancer. Specifically, tracking health remotely and maintaining regular communication with healthcare providers can reduce symptoms and prevent hospital visits. Research indicates that home-based cancer care not only manages symptoms effectively but also reduces healthcare costs. Initial findings suggest that this type of care practically supports patients after hospital discharge. Overall, this approach ensures patients receive continuous and personalized care at home. ^{1 6 7 8 9}

Who Is on the Research Team?

Ryan D Nipp, MD

Principal Investigator

Massachusetts General Hospital

Are You a Good Fit for This Trial?

This trial is for English-speaking adults over 18 with advanced cancer, recently hospitalized at MGH without ICU care. They must live within 50 miles of MGH and be discharged home, not to hospice or other locations. Caregivers and clinicians involved in their care are also eligible if they meet similar criteria.

Inclusion Criteria

Caregiver Eligibility

I am diagnosed with advanced cancer and am receiving treatment to ease symptoms.

Patient Eligibility

Exclusion Criteria

I am currently in the intensive care unit.

Caregiver Exclusion

I am scheduled for a surgery or medical procedure that requires a hospital stay.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive the Supportive Oncology Care at Home program, which includes remote monitoring and home-based care, for 14 days following hospital discharge

2 weeks

Daily remote monitoring

Follow-up

Participants are monitored for safety and effectiveness after the treatment phase, including assessments of quality of life and symptom burden

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Supportive Oncology Care at Home

Trial Overview

The study tests a home-based supportive oncology care program post-discharge involving remote monitoring (symptoms, vitals), Medically Home model for symptom management, and structured communication with the oncology team.

How Is the Trial Designed?

Group I: Supportive Oncology Care at Home Experimental Treatment 1 Intervention

Participants will receive the Supportive Oncology Care at Home program for 14 days following their discharge from the hospital. The Supportive Oncology Care at Home intervention consists of three key components: * Daily monitoring of patient-reported symptoms, vital signs, and body weight. * Medically Home care based on algorithmic changes in patients' daily symptoms, vital signs, and body weight. * Structured communication with the oncology team regarding care delivered to ensure continuity of care.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Medically Home Group, Inc.

Collaborator

Trials

1

Recruited

110+

Published Research Related to This Trial

A study involving 218 advanced non-ambulatory cancer patients found that comprehensive home treatment led to reduced need for narcotic pain relief, fewer hospitalizations, and improved nutritional status, particularly in female patients.

Home treatment was well-accepted by patients and families, and it proved to be an effective alternative to hospital care, especially for those with better performance status, while not affecting survival rates for patients with lower performance status.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparative assessment of home versus hospital comprehensive treatment for advanced cancer patients. Vinciguerra, V., Degnan, TJ., Sciortino, A., et al.[2017]

In a study involving 97 patients with various advanced cancers, outpatient home anti-cancer chemotherapy showed effective results with no severe side effects, allowing patients to maintain a good quality of life during treatment.

The success of this outpatient approach highlights the importance of establishing dedicated therapy rooms and training expert nurses to ensure safe and effective administration of chemotherapy at home.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Our outpatient cases for home anti-cancer chemotherapy]. Midorikawa, Y., Suzuki, K., Kasuga, T., et al.[2006]

The hospital-at-home care program by ANT for advanced cancer patients has successfully treated 5,603 patients from 1985 to 1991, achieving a 70% rate of deaths occurring at home, which indicates a preference for home-based end-of-life care.

Pain control was effectively managed in 95% of cases, highlighting the program's efficacy in symptom management, while suggesting that eligibility for home care should consider not just medical status but also social and psychological factors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Bologna Eubiosia Project: hospital-at-home care for advanced cancer patients. Pannuti, F., Tanneberger, S.[2017]

A multicenter study involving 104 patients with newly diagnosed acute myeloid leukemia demonstrated that home-based intensive chemotherapy is feasible and safe, with 67% of treatment days conducted at home using infusion pumps.

Patients reported high satisfaction with home treatment, which positively impacted their quality of life, allowing them to remain socially and physically active during chemotherapy without any unexpected adverse events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A national Danish proof of concept on feasibility and safety of home -based intensive chemotherapy in patients with acute myeloid leukemia. Nørskov, KH., Fridthjof, K., Kampmann, P., et al.[2022]

In a study of 175 participants, those receiving ambulatory home-based chemotherapy experienced significantly fewer severe adverse events like anemia, neutropenia, and thrombocytopenia compared to those receiving inpatient chemotherapy.

Patients in the ambulatory home-based chemotherapy group reported better social well-being, indicating that this treatment approach may enhance quality of life despite experiencing more common side effects like nausea and fatigue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of adverse events and health-related quality of life in patients with colorectal cancer receiving ambulatory home-based chemotherapy in Thailand. Sirilerttrakul, S., Wannakansophon, N., Utthiya, P., et al.[2021]

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