OBJECTIVES : Cancer treatment includes conventional clinic-based infusions and various options for home administration of medication. Clinic-based treatment can be disruptive and costly to patients and caregivers, requiring transportation, time away from work/family responsibilities, and stressful clinical settings. Potential benefits to home-based chemotherapy include cost/healthcare resource utilization savings and decreased infection exposure by avoiding clinical settings. This literature review evaluated patient- and caregiver-relevant advantages of home-administered cancer therapy.

METHODS : A targeted PubMed review was undertaken, with supplemental gray literature searches, for reports of patient preference and patient/caregiver-reported outcomes regarding cancer treatment administration settings. Selected studies had ≥10 subjects and were conducted from 1995 to 2019, with no limits for geography or cancer type.

RESULTS : Twenty studies involving both hematologic cancers and solid tumors were identified from North America, Europe, Asia, and Australia. Cancer therapy was administered by patients/caregivers (ie, oral or subcutaneous) or a visiting nurse. All the studies reviewed reported benefits for home- vs clinic-based treatment. Patient expressed preference/satisfaction and willingness to continue with home-based regimens; while methodologies varied among studies, >90% of patients preferred home administration. Across studies, over half of patients receiving home treatment cited improvement in outcomes including QoL, well-being, activities of daily living, and family/social life. Patients cited benefits including convenience, comfort, reduced travel/financial burden, limited waiting time, and greater ability to maintain daily family/social activities.

CONCLUSIONS : This targeted literature review consistently found patient-relevant benefits with home-administered chemotherapy. Less information is available on caregiver-reported outcomes, which should be assessed in future research given that home-based cancer treatment impacts caregivers as well as patients. Home-based treatment may enhance quality of survival time and reduce healthcare resource utilization while maintaining clinical benefits of treatment. While treatment decisions should account for patient preference for home-based treatment, some treatment pathways will require care at an outpatient or inpatient facility.