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Assessing acceptability of home blood monitoring for cancer patients who are receiving systemic anti-cancer therapy from a patient, caregiver, and clinician perspective: a qualitative study
ABSTRACT
Background:
Regular blood testing is an integral part of systemic anti-cancer therapy delivery. Blood tests are required before every administration of treatment to ensure a patient is well enough to receive it. Blood testing is burdensome for patients as they require either an extra visit within 48 hours of planned administration, or a significantly longer visit if done on the day of treatment. The additional time for appointments can have a significant impact upon the quality of life of someone who is living with cancer. In the UK the COVID-19 pandemic created an unprecedented disruption to the delivery of cancer care. Face to face hospital visits were reduced, resulting in a need to develop more innovative ways of working to minimise treatment interruptions. This led to a significant uptake of digital technologies, with new models of care rapidly deployed across the UK health service to meet these challenges.
Objective:
In this study we explore the acceptability of a point of care home blood monitoring device for people with cancer who are receiving systemic anti-cancer therapy, which is being developed in response to the increased need for remote care for patients with cancer.
Methods:
Qualitative focus groups and semi-structured interviews were conducted with patients (n=23), caregivers (n=6), and healthcare professionals (n=18) over a 19-month timeframe, from May 2019 to December 2020. Data were analysed using framework analysis guided by the Unified Theory of Acceptance and Use of Technology model.
Results:
Analysis identified four overarching themes: 1) performance expectancy; 2) effort expectancy; 3) social influence; 4) facilitating conditions.
Conclusions:
This study found that patients with cancer, caregivers, and healthcare professionals had positive perceptions of home blood monitoring. Whilst they are often considered synonymously, self-testing and self-management are not mutually exclusive, and this study illustrated some disparity in opinion regarding patient self-management. Home blood monitoring has the potential to provide patients with cancer with a convenient option for blood monitoring. It would minimise hospital attendances, decrease late treatment deferrals, and provide prompt recognition of cancer treatment toxicities, enhancing existing nurse-led protocols and clinical pathways. Home blood monitoring would create a long-term sustainable transformation for the delivery of cancer care, utilising digital health to act as a facilitator to address a pertinent issue regarding improving the efficiency of hospital resources and increasing the delivery of personalised patient care. Clinical Trial: REC Reference 18/EE/0343, IRAS project ID 234137
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