Evaluations will be conducted by telephone 15 days after hospital discharge, 30 days and then every month until 6 months.

Medical telephone contact

Marie-Christine GRACH, MD

The proposed work is part of a multidisciplinary approach to continuity of care in the particular context of the palliative phase of cancer. In conducting this study, we would like to characterize, at the regional level, satisfaction with the care of patients and their families in their care home situations palliative cancer. This evaluation will be based on questionnaires adapted versions in French language satisfaction questionnaires recently validated for patients in palliative situation and supported home care.

It will also identify the challenges faced by both patients, caregivers attending physicians.

The evaluation of these elements is a prerequisite to propose ways of improving at a hospital palliative care for output relay and anticipate the coordination of care for optimal care of the patient at home, to meet the expectations of different stakeholders, or even prevent certain readmissions "avoidable".

- Background and rationale of the research project Palliative care is defined, according to the French Society for Support and Palliative Care as acute care delivered in a comprehensive approach to the person with a serious illness, progressive or terminal. Their goal is to relieve physical pain and other symptoms, but also take into account the psychological, social and spiritual suffering. According to this definition, palliative care is interdisciplinary, cater to the patient as a person and his family, at home or in an institution and strive to preserve the best possible quality of life until death.

Very few studies on the quality of life for patients at end of life were conducted in France. Among them, the TRAPADO study is a prospective study to evaluate the quality of care, quality of life and impact on the environment in three parallel cohorts of cancer patients in palliative phase according to their choice of inpatient traditional in palliative care or home. The interim analysis of this study, was published in 2006 in the journal Bulletin of cancer: patients expressed a priority choice for the home; there was a marked alteration of the overall quality of life, as measured by the EORTC-QLQC30, no statistically significant difference between home and hospital; anxiety level was higher in the hospital. Relatives were satisfied with the care of the patient with a good perception of the family fabric and expressed a lower level of psychosocial distress at home. Nevertheless, the terminal readmissions were common with a large majority of hospital deaths.

More recently, Régis Aubry, in the framework of the National Observatory on End of Life (ONFV), has conducted an extensive field survey, published in March 2013, up to the caregivers who meet together near home but also health professionals involved in supporting patients at end of life. The report of this work highlights the importance of developing palliative care in the home including the intervention of specialized teams and coordination of teams working at home.

Indeed, in France, while 81% of the French would "spend their last moments at home" (FIFG, 2010), only 25.5% of deaths occur at home (ONFV, 2012).

Faced with this reality, we were asked to know what elements can explain this discrepancy between this reality and the desire of patients. This issue was the subject of a preliminary study, conducted in 2013 in Lower Normandy region. We chose to study the management of patients with cancer in palliative home situation by their GP after hospitalization Identified beds Palliative Care (LISP) Centre François Baclesse Caen: 19 of the 23 patients assessed, have expressed their willingness on the place of death to their GP, wanted to die at home. Nearly half (48%) of patients in our study died in the hospital. GPs interviewed reported that maintaining the homes of these patients had been facilitated by the relief of distressing symptoms and the establishment of aid.

This finding demonstrates that the GP can often not only coordinate the sometimes complex palliative situations, at home and that the intervention of specialized teams, interdisciplinary, is fundamental to maintaining a home in the best possible conditions.

But what about the patient felt about his quality of life at home? After collecting feedback from GPs Lower Normandy, we would like to continue this work. In this context, we propose a pilot study, single-center, to assess the satisfaction of patients and their families in home support palliative phase of cancer.

- Emerging nature of research topics covered: The proposed work is part of a multidisciplinary approach to continuity of care in the particular context of the palliative phase of cancer. In conducting this study, we would like to characterize, at the regional level, satisfaction with the care of patients and their families in their care home situations palliative cancer. This evaluation will be based on questionnaires adapted versions in French language satisfaction questionnaires recently validated for patients in palliative situation and supported home care.

It will also identify the challenges faced by both patients, caregivers attending physicians.

The evaluation of these elements is a prerequisite to propose ways of improving at a hospital palliative care for output relay and anticipate the coordination of care for optimal care of the patient at home, to meet the expectations of different stakeholders, or even prevent certain readmissions "avoidable".

- Degree of risk-taking and innovative scientific approach: The situation at the end of life patient palliative situation of cancer remains a research context underdeveloped. This study is based on the involvement of patients and their caregivers, at this stage of the disease to assess their satisfaction with care when returning home after a hospital palliative care. It proposes indeed used for this self-administered to patients and their caregivers questionnaires adapted questionnaires in French version of the research team CANHELP.

- Impact and potential consequences of the project: The proposed pilot study should document the satisfaction What patients in palliative situation of their cancer during their care at home, as well as those around them, at the regional level. The implementation of this project will also be used to validate the feasibility of involving these actors in the difficult context of the end of life, to understand their needs, difficulties and feelings regarding the effective care . Thereafter, it may be considered a larger study to complete these first results, before proposing ways to improve whose impact on satisfaction with care remain to be evaluated.

Assessment of Patient Satisfaction in Palliative Cancer When They Return Home After Hospitalization in Palliative Care

Evaluation of the quality of life of patients at home over time.

Characterize the type and intensity of symptoms, physical and mental, and supported over time;

Evaluation of satisfaction with the care of patients in palliative phase of cancer 15 days after their home return after hospitalization in palliative care.

Evaluation of the satisfaction of the primary caregiver of maintaining the home of his relatives with cancer in palliative phase

Centre Francois Baclesse

Adult patients with solid tumours receiving systemic anti-cancer therapy who are able to use the Minicare H-2000.

Patients will use the Minicare H-2000 at home to measure their capillary blood count, temperature, record questionnaire results and transfer the results via the 3G network to the hospital team.

Minicare H-2000

Geoff Hall, PhD, FRCP

Elaine Dunwoodie, MB ChB

The investigators hypothesise that cancer patients on systemic anticancer therapy can measure a home blood count, temperature, record qualitative data and transfer the results electronically to the hospital clinical team.

A low neutrophil blood cell count (neutropenia) can be a dose-limiting toxicity of systemic anti-cancer therapy (SACT) and can be life-threatening when complicated by sepsis. Neutrophil count is usually obtained by venepuncture by a health-care professional. The Minicare H-2000 is a new device which facilitates home self-testing of blood count, temperature and symptoms. The four components are i) blood count recorder using a capillary sample obtained via finger-prick ii) Bluetooth linked thermometer iii) tele-hub collecting patient-reported outcomes and iv) secure communication through the 3G network.

The investigators propose a single-centre, non-randomised feasibility study to test the process of patients on chemotherapy using the Minicare H-2000 to deliver self-tested blood count readings, temperature and qualitative data electronically to the hospital clinical team. The aim is to test training of patients to use a finger-prick method of obtaining blood count, patient ability to perform the test, retention of training, the ability of the Minicare H-2000 to facilitate the data transfer and to test the secondary care interface. This study will provide preliminary data on the potential of Minicare H-2000 to prevent wasted hospital journeys when the blood count has not recovered sufficiently for subsequent SACT cycles. The investigators intend to obtain informed consent to recruit between 30 to 80 patients to this study which will be performed in addition to current local standard of care.

This study enables identification of suboptimal areas of the process prior to investigating the application of the minicare H-2000 within oncology to improve the clinical patient pathway. The investigators ongoing intentions are to trial the use of the Minicare H-2000 to reduce frequency and severity of neutropenic complications, prevent wasted hospital journeys and hospital resources, reduce non-elective hospital admissions and personalise delivery of SACT.

Home Testing of Blood Counts in Chemotherapy Patients

A Phase 1 Trial Assessing the Safety and Performance of the Minicare H-2000 in Home Testing of Blood Counts in Chemotherapy Patients.

Accuracy of the Minicare H-2000 granulocyte measuring technology will be confirmed using Pearson's correlation co-effcient and R squared.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Assessment of Patient Satisfaction in Palliative Cancer When They Return Home After Hospitalization in Palliative Care	NCT02207543	Cancer Palliative Care Home	Medical telepho...	18 Years -	Centre Francois Baclesse
Home Testing of Blood Counts in Chemotherapy Patients	NCT02234453	Cancer	Minicare H-2000	18 Years -	University of Leeds
Assessment of Patient Satisfaction in Palliative Cancer When They Return Home After Hospitalization in Palliative Care	NCT02207543	Cancer Palliative Care Home	Medical telepho...	18 Years -	Centre Francois Baclesse

Spots Global Cancer Trial Database for home

Every month we try and update this database with for home cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for home

Every month we try and update this database with for home cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for home cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.