Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

COVID-19 prompts rapid and safe transition of chemotherapy into homes (#150)

Julie Adams 1 2 , Andrew Vanlint 3 4 , Timothy Price 4
  1. View Health - chemo@home, West Perth, WA, Australia
  2. chemo@home, West Perth, WA, Australia
  3. Central Adelaide Local Health Network, Adelaide, SA, Australia
  4. University of Adelaide, Adelaide, SA, Australia

Background

With the identification of the COVID-19 pandemic in early 2020, cancer services in South Australia moved quickly to protect patients on anti-cancer treatment (ACT) who are particularly vulnerable to infective complications. Home chemotherapy (HC) was identified by Royal Adelaide Hospital Cancer Services as a strategy that could mitigate the risk of nosocomial COVID-19 infection. 

Aim

To develop and implement a process for the rapid transition of patients on ACT from the day-unit (DU) to the home setting.

Method

A partnership was created with a well-established private HC provider, chemo@home, and patients were prioritised through a collaborative approach as follows:

  1. Patients required to attend > 4 visits/month, those in care facilities or difficulty with ambulation;
  2. Patients receiving immunotherapy, treatment for breast cancer, and selected lymphoma therapies; and
  3. Patients receiving other therapies including treatment for colorectal cancer.

The process involved: identification of patients by DU staff; review by Clinical Operations Manager; approval by Specialists; streamlining referral by chemo@home liaison; admission, appointment, pharmacy review, treatment and correspondence by chemo@home.

Results

Over the period April - July 2020, chemo@home provided 600 home ACTs. There were no major adverse events or safety incidents. Additional benefits to HC came to light including the safety of home isolation, reduced patient transport needs and associated expenses, higher levels of patient support and education, and reduced patient and visitor traffic in hospitals.

Conclusion

With appropriate clinical governance and specialist oversight, the use of an HC service enabled the rapid transition of patients on ACT from the DU to the home during the COVID-19 pandemic.  The Gratten Institute’s report for the Australian post-pandemic context1 makes a clear call for increases to out-of-hospital and in-home services to augment or replace existing inpatient delivery models, and as such further expansion of HC services will likely become part of standard clinical practice,

  1. 1. Duckett, S., Mackey, W., Stobart, A., Swerissen, H., and Parsonage, H. (2020). Coming out of COVID-19 lockdown: the next steps for Australian health care. Grattan Institute.