Why Patients Decline or Are Being Deemed Ineligible to Receive Home-based Treatment: a Mixed Methods Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 50
- 试验地点
- 3
研究概览
简要总结
Treatment for blood cancers has improved significantly, and more patients are now living longer. However, these treatments are often intensive and long-lasting, and many patients experience serious side effects and symptoms. As more patients require ongoing treatment and long-term care, the demand for haematology services is increasing.
Home-based treatment is expected to play an increasingly important role in the future. It can support more patient-centred care, help patients maintain their everyday lives, improve quality of life, and reduce pressure on hospitals. Despite these benefits, some patients are either not eligible for home-based treatment or choose to decline it. The reasons for this are not yet well understood.
This study combines quantitative data-such as medical information, sociodemographic characteristics, and questionnaire responses about quality of life and health literacy-with qualitative interviews involving patients, relatives, and healthcare professionals. The aim is to identify barriers and differences between patients, and to better understand why some patients opt out of or are unable to participate in home-based treatment.
The findings will help support the development of more inclusive and patient-centred care models, ensure more equal access to home-based treatment, and improve support for socially vulnerable patients. The results will be shared with patients and families through patient organisations, with hospitals through the Treat@Home programme, and at national and international conferences.
详细描述
Background Advances in treatment have improved survival for patients with hematologic malignancies, yet these patients remain at risk of severe complications and a high symptom burden.
As more patients require treatment and long-term care, the demand for hematologic services continues to grow. Home-based treatment is therefore expected to play an increasingly important role, with the potential to enhance patient-centered care, support daily life, improve quality of life, and reduce hospital burden. However, a proportion of patients do not meet the eligibility requirements for home-based treatment, and others choose to decline this option despite being offered the opportunity. Understanding the characteristics, experiences, and perspectives of these patients is essential for developing equitable, patient-centered approaches to treatment delivery and ensuring that home-based care models do not inadvertently exacerbate health disparities. Understanding this knowledge gap is crucial. These patients often undergo long, intensive treatment, and socially vulnerable patients may face additional practical, emotional, or social challenges. Home-based treatment could provide flexibility and support to reduce such inequalities. Without insight into why some patients decline or are ineligible for home-based treatment, there is a risk that these models will primarily serve more resourceful patients, potentially reinforcing health disparities.
The overall aim of this mixed methods study is to investigate reasons for declining or being deemed ineligible for home-based treatment among patients with hematologic malignancies, their caregivers and healthcare professionals.
This will be addressed with the following questions:
- Are there differences in medical, sociodemographic, and patient-reported outcomes between patients who decline or are ineligible for home-based treatment and those who accept it?
- What barriers exist to receive home-based treatment for a hematologic malignant disease?
- How do combined insights from the qualitative and quantitative data enhance understanding on barriers to home-based treatment? Methods Context This study is part of the Treat@Home research program, which aims to generate evidence on home-based interventions for patients with hematologic malignancies in Denmark. The program is anchored at the Department of Hematology, Zealand University Hospital (ZUH) and is led by the head of program and main applicant. It is supported by a management team and a national research group with interdisciplinary representatives from hematology departments across all Danish regions. In addition to several individual studies, the program includes two PhD projects investigating the implementation of home-based treatment with Daratumumab for multiple myeloma and Cytarabine for acute leukemia.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 100 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •>=18 years old
- •diagnosed Multiple Myeloma or acute leukemia, and recieving treatment with either Daratumumab or Cytarabine.
排除标准
- •- Dementia, psychotic disorders, or other cognitive impairments limiting participation.