Effect of a single home visit on distress in cancer patients undergoing chemotherapy: A comparative study.

Abstract

12107 Background: This study aimed to investigate whether a home visit after the first chemotherapy can significantly reduce cancer patients’ psychological distress levels. Methods: The National Comprehensive Cancer Network Distress Thermometer and problem list was used to assess patients’ level of distress on a scale from 0 to 10, with scores of 4 or higher considered a high level of distress. Between 01 Mar and 01 Nov 2024 chemotherapy naïve cancer patients were divided into two groups – the study group had a home visit by a medical oncologist within 10 days after the start of their 1st chemotherapy, and the patients in the control group were only seen at the clinic before the start of their 1st and 2nd chemotherapy course. During the home visits, a patient-led discussion was held, in which the oncologist answered various questions about the patient’s staging, prognosis, therapy and its anticipated effects. Home visits were offered to all patients, but only those who opted in received them. All patients in both groups had their distress levels assessed at two time points – before the start of 1st chemotherapy course and before the start of the 2nd chemotherapy course. Responses were analysed and compared between the two groups. Results: The level of psychological distress was assessed in 126 patients with solid tumours; of them, 88 (69.8%) opted in for a home visit and formed the study group, while 38 refused and were only seen at the clinic and served as the control group. Mean age in the study group was 60.6±12.4 and 56.9±14.4 for the controls. In both groups, breast, lung, and colon cancer prevailed. High baseline levels of distress (before the start of chemotherapy) were similarly prevalent in both groups: 72.7% of the home visit group and 65.8% of the control group scored 4 or higher. McNemar's test showed that the number of patients with high levels of distress at the second interview was significantly reduced in the home visit group, from 72.7% to 53.4% (p < 0.001), in contrast to the controls, where it remained almost unchanged from 65.8% to 68.4%. In addition, the Wilcoxon test showed that one home visit significantly decreased the level of distress in the study group, from 4.9±2.6 to 3.4±2.5 (p < 0.001). In contrast, distress levels in the control group, comprising patients who declined home visits, showed no significant improvement, barely dropping from 4.6±2.8 to 4.2±2.7 (p = 0.263) between the first and second interviews. Conclusions: This study demonstrates that a single home visit by an oncologist after the start of chemotherapy can significantly reduce distress levels in cancer patients and thus enhance overall patient well-being.