Supportive Transfusion Program for Patients With Hematologic Malignancies: A Cluster Randomized Trial

What this Trial Is About

Researchers are evaluating a new care program called HEME-Hospice that offers home blood transfusions for patients with blood cancers who are enrolled in hospice. The study compares this program to usual care to see if it improves hospice enrollment, quality of life, mood, and end-of-life healthcare use for patients with hematologic malignancies and their caregivers. Patients with blood cancers often face symptoms like fatigue and bleeding that transfusions can ease, but most hospices do not provide transfusions, limiting access to hospice care. The study is a cluster randomized trial where hematologic oncologists are randomly assigned to provide either access to the HEME-Hospice program or usual care. Patients whose doctors are assigned to HEME-Hospice will receive weekly symptom assessments and home transfusions as needed, with hospice care tailored to individual needs. Those in usual care receive standard oncology treatment and may enroll in regular hospice care if they choose. Participants will be monitored over six months for hospice enrollment rates, length of hospice stay, quality of life, mood, and healthcare utilization near the end of life. Assessments include patient and caregiver quality of life, anxiety, depression, and hospital use during the last month of life. The study team provides ongoing symptom evaluation and records transfusion treatments, aiming to understand how home transfusions affect patient and caregiver experiences and healthcare outcomes in hospice.

HEME Home Transfusion Program