The Relationship between Quality of Life and Different Models of Home Care among Terminal Cancer Patients in an Health Area of Madrid, Spain

Abstract

Background: This study assesses the effectiveness of the palliative home care for the purpose of ascertaining whether terminal cancer patients treated by Homecare Support Teams have a better quality of life than those treated by Primary Care Teams. Methods: A quasi-experimental prospective study conducted in Madrid Healthcare District 4 on patients referred from the hospital to Homecare Support Teams or to Primary Care Teams. The main study variable was the quality of life gauged using the Rotterdam Symptom Check List and the Hospital Anxiety and Depression Scale. Statistical differences were evaluated by MANOVA, repeated measures ANOVA and Friedman test. Results: A total of 165 patients were treated by Homecare Support Teams and 56 by Primary Care Teams. The patients treated by the Homecare Support Teams showed better point scores on the overall scale (mean differece: 9.5; CI 95%; 2.3-16.67) and pain scale (mean difference: 6.4; CI 9%; 1.14-11.43) on the Rotterdam Symptom Check List during the first week of the study. The effect size was greater on the Homecare Support Team group. The prescription of drugs and the place of death were different between both groups. Conclusions: At the start of the study, the patients treated by Homecare Support Teams showed a better perception of the health condition than those treated by the Primary Care Teams. However, the great number of patients lost along the study makes it necessary be cautious when considering these results.