Home Delivery: Transfusion Services When and Where They Are Needed

Area of Science:

• Hematology
• Transfusion Medicine
• Healthcare Management

Background:

• Decentralizing hospital care, including home blood product transfusion, is gaining traction globally.
• Motivations include enhancing patient independence, reducing healthcare costs, and preventing hospital-acquired infections, particularly highlighted by the COVID-19 pandemic.
• The shift towards 'hospital in the home' models aims to improve patient outcomes, satisfaction, and address acute care capacity pressures.

Purpose of the Study:

• To review the existing literature on home red cell and platelet transfusions.
• To explore potential benefits and safety considerations of home transfusion therapies.
• To identify gaps in current research, such as quality of life improvements, health-related outcomes, and cost-effectiveness.

Main Methods:

• Systematic review of published literature on home red cell and platelet transfusions.
• Inclusion of data from subcutaneous immunoglobulin studies where literature on blood products is limited.
• Analysis of reported benefits, safety data, and identified research needs.

Main Results:

• Published data indicate benefits for both patients and the health service from home red cell and platelet transfusions.
• Serious adverse reactions associated with home transfusion appear to be rare.
• Significant limitations exist in current data regarding quality of life, health-related outcomes, and cost-effectiveness.

Conclusions:

• Home transfusion of red cells and platelets demonstrates potential advantages for patients and healthcare systems.
• Perceived safety barriers may be mitigated by existing data showing low rates of serious adverse events.
• Further research is crucial to quantify quality of life improvements, health outcomes, and economic viability, with potential integration of new technologies.