CONTINUUM: A Post-Discharge Supportive Care Intervention for Hospitalized Patients with Advanced Cancer

Abstract

ContextPatients with advanced cancer are at increased risk for multiple hospitalizations and often have considerable needs post-discharge. Interventions to address patients’ needs after transitioning home are lacking. ObjectivesWe sought to demonstrate the feasibility and acceptability of a post-discharge intervention for this population. MethodsWe conducted a single-arm pilot trial (n=54) of a post-discharge intervention, consisting of a video visit with an oncology nurse practitioner (NP) within three days of discharge to address symptoms, medications, hospitalization-related issues, and care coordination. We enrolled English-speaking adults with advanced breast, gastrointestinal, genitourinary, or thoracic cancers experiencing an unplanned hospitalization and preparing for discharge home. The intervention was deemed feasible if ≥70% of approached patients enrolled and ≥70% of enrolled patients completed the intervention within three days of discharge. Two weeks after discharge, patients rated the ease and usefulness of the video technology on a 0-10 scale (higher scores indicate greater ease of use). NPs completed post-intervention surveys to assess protocol adherence. ResultsWe enrolled 54 of 75 approached patients (77.3%). Of enrolled patients (median age=65.0 years), 83.3% participated in the intervention within three days of discharge. The median ease of participating in the intervention was 9.0 (IQR: 6.0-10.0) and the median usefulness of the intervention was 7.0 (IQR: 4.5-8.0). The majority of visits focused on symptom management (85.7%), followed by post-hospital medical issues (69.0%). ConclusionAn oncology NP-delivered intervention immediately after hospital discharge is a feasible and acceptable approach to providing post-discharge care for hospitalized patients with advanced cancer.