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Implementation of a hospital-at-home (HAH) unit for hematological patients during the COVID-19 pandemic: safety and feasibility

2021; Springer Science+Business Media; Volume: 115; Issue: 1 Linguagem: Inglês

10.1007/s12185-021-03219-2

1865-3774

Ignacio Gómez‐Centurión, Gillen Oarbeascoa, M. C. Garcı́a, María Carmen López Fresneña, María Josefa Martínez Carreño, Vicente Escudero Vilaplana, Eva González-Haba, Rebeca Bailén, Nieves Dorado, Luis Miguel Juárez‐Salcedo, Gabriela Rodríguez Macias, Patricia Font, Cristina Encinas, Mariana Bastos‐Oreiro, Javier Anguita, María Sanjurjo‐Sáez, José L. Díez‐Martín, Mi Kwon,

COVID-19 Clinical Research Studies

"Hospital-at-home" (HAH) programs have been shown to optimize resource utilization, shorten hospitalization and prevent nosocomial infection.We retrospectively analysed data regarding implementation of an HAH unit for caring patients with hematological malignancies in our center, during the COVID-19 pandemic.Between January and November 2020, 105 patients were treated in the HAH unit for a total of 204 episodes. Nine patients with multiple myeloma (MM) received autologous HSCT (auto-HSCT). Three patients with acute myeloid leukemia (AML) received consolidation therapy, 32 patients underwent clinical and analytical monitoring, 20 were transplant recipients early discharged (5 auto-HSCT and 15 allo-HSCT) and 2 had received CART cells therapy. Azacitidine, bortezomib and carfilzomib were administered at home to 54 patients with AML, myelodysplastic syndrome (MDS) or MM. A median of 17 (IQR 13-19) days of admission per patient and a total of 239 visits to the Hematology day-care hospital were avoided. Overall, 28 patients (14% of all episodes) needed admission to the hospital, 4 of them due to COVID-19.Implementation of a Hematology HAH unit was feasible and safe, and provided thorough advanced care to a high-risk population. Advanced care-at-home strategies can be crucial during times of COVID-19 to minimize treatment interruptions and reduce the risk of cross-infections.