Organizational and Patient Perspectives of at Home Cancer Treatment

Abstract

Introduktion: Hæmatologisk kræft er en belastende sygdomsgruppe, som p˚ avirker millioner af mennesker p˚averdensplan og er en af de mest almindeligt forekommende cancergrupper i Danmark. Stigningen af ældre i be folkning har ført til en stigning i antallet af mennesker der f˚ ar diagnosticeret hæmatologisk kræft samt et øget pres p˚asundhedsvæsenet, hvilket har ført til et behov for alternative behandlingsmetoder, s˚ asom at flytte behandlinger hjem til patienten. Dette studie undersøgte den nuværende organisering af hjemmebehandling af hæmatologiske kræftpatienter ved at udføre en dokumentanalyse og semistrukturerede interviews af patienter med hæmatologisk kræft som modtager subkutan hjemmebehandling for at undersøge deres oplevelser og opfattelser af behandlingen. Metode: Studiet var opdelt i tre delstudier med hver deres metode. Det første delstudie var en organisatorisk analyse af de nuværende hjemmebehandlingsmuligheder og en dokumentanalyse af retningslinjer for hjemmebe handling p˚a tværs af regioner. Det næste delstudie var en systematisk literatursøgning for at finde studier hvor metoden er semistrukturerede interviews af kræftpatienter i hjemmebehandling for at undersøge deres oplevelser og opfattelser af behandlingen. Det sidste delstudie omhandlede det semistrukturerede interview af hæmatolo giske kræftpatienter som modtager hjemmebehandling. Interviewtranskriberingerne blev analyseret ved brug af tematisk analyse. Resultater: Den organisatoriske analyse blev udført p˚ a retningslinjerne for hjemmebehandling af de subku tane behandlinger daratumumab, azacitidin og bortezomib i de regioner som havde udgivet dem. Den systematiske literatursøgning resulterede i tre studier som var egnede til inklusion. Yderligere et studie var tilføjet efter at have lavet en kædesøgning p˚ a de tre inkluderede studier. Der blev foretaget interviews af fire patienter med hæmatologisk kræft. Fra interviews blev tre temaer konstrueret: ’Logistic aspect’, ’Personal relation to home treatment’ og ’The importance of relation to HCP’s’. Konklusion: Den organisatoriske analyser viser nogle forskelle mellem hjemmebehandlingsinstrukserne for daratumumab, azacitidin og bortezomib. De tre temaer og viden fra interviews fungerer som indledende forskning af oplevelser og opfattelser blandt hæmatologiske kræftpatienter som modtager subkutan hjemmebehandling i Danmark

Introduction: Hematologic cancer is a burdensome disease, affecting millions of people worldwide and is also one of the most common cancer groups in Denmark. The increase in the elderly population has caused an increase in the number of people getting hematologic cancer and also led to a pressure on the healthcare system, leading to the need for alternative healthcare methods such as moving treatment home. This study investigated the current landscape of home treatment for hematologic cancer patients by conducting a document analysis and semi-structured interviews with hematologic cancer patients receiving at-home subcutaneous cancer treatment, exploring their experiences and perspectives of the treatment. Methods: The study was divided into three substudies with each of their methods. The first substudy is an organizational analysis of the current at-home treatment options and a document analysis of home treatment guidelines across regions. The second is a systematic literature search of existing studies of semi-structured inter views of cancer patients receiving at-home chemotherapy investigating their experiences and perceptions of their treatment. Furthermore, the systematic literature search provided information for the creation of the interview guide for the present study. The third substudy was a semi-structured interview of hematologic cancer patients receiving at-home subcutaneous treatment. The interviews transcripts were analyzed using thematic analysis. Results: The organizational analysis was conducted on home treatment guidelines for the subcutaneous treatments daratumumab, azacitidine and bortezomib in the regions which had published home treatment guide lines. The systematic literature search resulted in three studies eligible for inclusion. An additional study was included from an chain search, resulting in four studies. Interviews were conducted of four hematologic cancer patient receiving home treatment between 7th of April and the 22nd of April 2025. From the interviews, three themes were developed: ’Logistic aspect’, ’Personal relation to home treatment’ and ’The importance of relation to HCP’s’. Conclusion: The organizational analysis finds some differences between the at-home treatment guidelines for daratumumab, azacitidine and bortezomib. The three themes identified and the knowledge gained from the interviews serve as a preliminary investigation into the experiences and perceptions of hematologic cancer patients receiving subcutaneous at-home treatment in Denmark

A master thesis from Aalborg University

Organizational and Patient Perspectives of at Home Cancer Treatment - a Qualitative Approach