Moving cancer care closer to home: a single-centre experience of home chemotherapy administration for patients with myelodysplastic syndrome

Myelodysplastic syndrome (MDS) is a disease of elderly with a median age of 70.1 Azacitidine is approved for high-risk MDS, chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML) with less than 30% blasts.2 Treatment with azacitidine has shown reduced transfusion requirement, improved leukaemia-free and overall survival.2 3 However, many elderly patients may find it difficult to attend day case 7 days a month until progression and further additional attendances for blood tests, clinics and transfusions. We recognised that the requirement for patients to make multiple hospital visits for chemotherapy treatment was having an increasingly negative impact on their quality of life and that of their relatives/carers. This also resulted in patients declining accessible treatment for their disease. Community chemotherapy service was set up with a view to improve the outcome and quality of care by taking treatment closer to home. National Health Service white paper in 2010 focused on extending choice for patients and moving cancer services away from major cancer centres when feasible. Key driver for community chemotherapy is improved patient choice and experience.4 5 In this article, we explain our community chemotherapy initiative project and our experiences so far. ### Aim The initial aim of the service was to reduce the number of visits required by patients to hospital, giving greater choice in the delivery of their treatment and therefore reducing the impact of their disease on their daily lives. The service was also aimed to increase efficiency in the delivery of chemotherapy by the Trust. These continued to be the overarching aims of the service to ultimately improve the experience of our patients and efficiency of the service. ### Project details All suitable patients who are under the care of a Heart of England Foundation Trust (HEFT) haematology consultants receiving treatment with subcutaneous chemotherapy within the Birmingham …