A novel patient-centered outcome in cancer care, days at home: a scoping review and guide for its future use

Days at home (DAH) is a global measure that measures time spent outside of healthcare institutions. There is currently no consensus regarding use, terms, or definitions. We conducted a scoping review to map the literature on DAH in cancer research, highlight its use, and perform an analysis to guide future use.

The objectives and methods were published a priori and designed using the JBI Manual for Evidence Synthesis and Arksey and O'Malley's expanded framework. The final search was run for Medline, Embase, and Scopus in February 2024 and captured adult cancer research where DAH, or equivalent, was measured. DAH was defined as a composite outcome, recording the time a patient spends alive and outside of healthcare institutions.

Of 1022 studies screened, 53 were included. The number of publications increased annually across study designs, with 16 studies published in 2023. DAH was assessed across multiple cancer populations, most commonly evaluating a heterogeneous cohort of cancer patients (14 studies, 26.4%). Sixteen unique terms were used to capture DAH, with days at home being most common (17 studies, 32%). There was variability in terms used, definitions applied, handling of death, and statistical methods when examining DAH. Several patient, cancer, treatment, and system level factors were associated with DAH across multiple cancer populations.

DAH may bridge the gap between methodologic rigor, data accessibility, and patient-centeredness in cancer research. There is considerable variability in terms, definitions, and reporting. With a view to coordinating the growing body of literature, we have shared considerations guided by this review to improve future use.