This research study is evaluating whether a new care delivery program that provides access to home blood transfusions in hospice (i.e, HEME-Hospice) compared to regular standard of care improves quality of life, mood, and end-of-life health care utilization for patients with hematologic malignancies.
Diagnosis of a relapsed/refractory hematologic malignancy
Age ≥ 18 years
Receipt of primary oncologic care at DFCI (at least 2 outpatient visits in 12 months prior to enrollment)
Has received at least one red blood cell (RBC) or platelet transfusion since blood cancer diagnosis in the clinic or hospital setting without a severe transfusion reaction
Age < 18 years
Already enrolled in hospice
Resides in nursing home or assisted living facility
History of previous serious adverse transfusion reaction
Parallel
HEME-Hospice Program
BehavioralA care delivery program that combines home-based transfusions with routine home hospice care. Transfusions are administered by trained transfusion nurses. Standard hospice care is provided by an interdisciplinary team of non-transfusion nurse case managers, hospice aides, social workers, and chaplains.
Hospice Enrollment Rate
Establish that hospice enrollment rate is higher with access to HEME-Hospice versus usual care.
Length of Hospice Enrollment
Number of days from hospice enrollment to date of death or hospice disenrollment
Chemotherapy Utilization in the Last 14 Days of Life
Compare chemotherapy use in the last 14 days of life between those with access to HEME-Hospice versus usual care
Hospitalization Rate
Compare hospitalization (2 or more hospitalizations) in the last 30 days of life between those with access to HEME-Hospice versus usual care
Intensive care unit (ICU) Admission Rate
Compare ICU admission in the last 30 days of life between those with access to HEME-Hospice versus usual care
Hospital Death
Compare occurrence of death in the hospital between those with access to HEME-Hospice versus usual care
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Dana-Farber Cancer Institute
Lead sponsor
National Cancer Institute (NCI)
Collaborator
