Use of Hospital-at-Home Services for Injectable Chemotherapy for Patients With Multiple Myeloma in France in 2019 and 2020: A Real-World Nationwide Study Based on the French Hospital Discharge Database

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EJHaem Pub Date : 2025-09-11 DOI:10.1002/jha2.70144

Laure Vincent, Anne-Sophie Jannot, Hakima Mechiche, Ulysse Rodts, Gaëlle Désaméricq

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Abstract

Background

Some injectable medicines introduced recently allow patients with multiple myeloma (MM) to receive their chemotherapy at home. This study aimed at describing adult patients with MM receiving injectable chemotherapy via hospital-at-home (HAH) services and outpatient hospital units (OHUs) in metropolitan France in 2019 and 2020, analyzing the factors influencing HAH use, and evaluating the geographic variations and the evolution over time of HAH use by these patients during the study period.

Methods

Real-world data from the French Hospital Discharge Database (PMSI) were analyzed.

Results

In total, 2169/9278 patients (23.4%) received at least one HAH chemotherapy injection. These patients were diagnosed more recently (mean ± standard deviation = 25.1 ± 19.6 vs. 31.6 ± 21.8 months), and lived in larger and wealthier cities (59,000 vs. 41,000 inhabitants; €23,300 ± €5300 vs. €21,700 ± €4100) and closer to their follow-up hospital (18.7 ± 18.4 vs. 31.3 ± 31.2 km) than patients exclusively treated in OHUs (p < 0.001). Receiving bortezomib and carfilzomib, and the first chemotherapy dose in 2020, were the most significant factors associated with HAH use (odds ratio [95% confidence interval]: 6.12 [5.40–6.96], 2.01 [1.69-2.39], and 1.81 [1.57–2.09], respectively, p < 0.001). HAH use increased between 2019 and 2020 (patients, +23%; administrative departments, +25%), likely related to the COVID-19 pandemic. However, HAH use remained limited overall and exhibited inter-regional variability. Infection-related hospitalizations remained stable.

Conclusions

Receiving chemotherapy injections at home is feasible and safe, but further development and equitable access are essential to enhance patients’ quality of life and reduce costs.

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2019年和2020年法国多发性骨髓瘤患者使用医院上门服务进行注射化疗：一项基于法国医院出院数据库的真实世界全国研究

背景：最近推出的一些注射药物允许多发性骨髓瘤（MM）患者在家接受化疗。本研究旨在描述2019年和2020年在法国大都市通过医院-家庭（HAH）服务和门诊医院单位（ohu）接受注射化疗的成年MM患者，分析影响HAH使用的因素，并评估这些患者在研究期间使用HAH的地理差异和时间演变。方法对来自法国医院出院数据库（PMSI）的真实数据进行分析。结果9278例患者中有2169例（23.4%）接受了至少一次HAH化疗注射。这些患者的诊断时间较晚（平均±标准差= 25.1±19.6对31.6±21.8个月），居住在较大和较富裕的城市（59,000对41,000居民；€23,300±€5300对€21,700±€4100），并且比仅在ohu治疗的患者更接近随访医院（18.7±18.4对31.3±31.2公里）（p < 0.001）。接受硼替佐米和卡非佐米以及2020年首次化疗剂量是影响HAH使用的最显著因素（优势比[95%置信区间]分别为6.12[5.40-6.96]、2.01[1.69-2.39]和1.81 [1.57-2.09],p < 0.001）。2019年至2020年期间，HAH使用率增加（患者，+23%；行政部门，+25%），可能与COVID-19大流行有关。然而，HAH的使用总体上仍然有限，并表现出区域间的差异。与感染有关的住院情况保持稳定。结论在家接受化疗注射是可行且安全的，但需要进一步发展和公平获取，以提高患者的生活质量和降低成本。

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EJHaem

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