EFFECTIVENESS OF HOME CARE PROGRAMS FOR PATIENTS WITH INCURABLE CANCER ON THEIR QUALITY-OF-LIFE AND TIME SPENT IN-HOSPITAL - SYSTEMATIC REVIEW

Objective: To investigate whether for patients with incurable cancer c omprehensive home care programmes are more effective than standard car e in maintaining the patients' quality of life and reducing their ''re admission time'' (percentage of days spent in hospital from start of c are till death). Design: Systematic review. Methods: A computer aided search was conducted using the databases of Medline, Embase, CancerLit , and PsychLit The search for studies and the assessment of the method ological quality of the relevant studies were performed by two investi gators, blinded from each other. Prospective, controlled studies inves tigating the effects of a home care intervention programme on patients ' quality of life or on readmission time were included in the analyses . Results: Only 9 prospective controlled studies were found; eight wer e performed in the United States and 1 in the United Kingdom. Their me thodological quality was judged to be moderate (median rating 62 on a 100 point scale). None of the studies showed a negative influence of h ome care interventions on quality of life: A significantly positive in fluence on the outcome measures was seen in 2 out of the 5 studies mea suring patients' satisfaction with care, in 3/7 studies measuring phys ical dimensions of quality of life, in 1/6 studies measuring psychosoc ial dimensions, and in 2/5 studies measuring readmission time. The inc orporation of team members' visits to patients at home or regular mult idisciplinary team meetings into the intervention programme seemed to be related to positive results. Conclusions: The effectiveness of comp rehensive home care programmes remains unclear. Given the enormity of the problems faced by society in caring for patients with terminal can cer, further research is urgently needed.