Quality of care of oncological patients with home parenteral nutrition

Purpose: Transferring adult cancer patients from the hospital to the home environment for home parenteral nutrition (HPN) can be challenging. There is limited real-world data on how those affected perceive this situation. Our aim was to assess the quality of life (QoL) on HPN and the benefits and burdens from the cancer patient's perspective.

Methods: This observational study from Germany examined the QoL on HPN on the basis of the Functional Assessment of Cancer Therapy - G questionnaire (FACT-G). The benefits and burdens of HPN were assessed using predefined questions and answers tailored to the situation of this patient group.

Results: 139 adults with advanced solid tumors in a palliative setting at 10 hospitals in Germany were eligible for the study. The follow-up was 12 weeks. At week 4, the Least-square (LS) mean (95% CI) change from baseline in the total FACT-G score was 0.9 (-2.4; 4.2) points, indicating QoL stability. HPN was associated with few complications, with a low rate of hospital readmission due to catheter-related issues (3.8%; n = 5). In the patient assessment of the benefits of HPN, the LS mean values at Week 4 ranged between 7.6 and 8.5 on a 10-point Likert scale. The most commonly perceived burden was "restricted mobility".

Conclusion: With thorough preparation for home parenteral nutrition, the transition from hospital to home care environment works well. QoL is largely maintained through HPN, and cancer patients perceive this situation as not or minimally burdensome alongside their underlying disease, although many patients found the limited mobility to be a burden.

Trial registration number: NCT03425435 / Date of registration: February 01, 2018.