Evaluation of patient experiences with a structured home treatment pathway for pulmonary embolism using direct oral anticoagulants

BACKGROUND: Patients with pulmonary embolism (PE) at low-risk for early PE-related complications can be treated safely at home. Patient satisfaction with such treatment has hardly been investigated. AIM: To evaluate patient satisfaction with PE home treatment. METHODS: We conducted a cross-sectional survey study to assess the experiences of PE patients treated at home. This study included consecutive adult patients diagnosed with PE between April 2024 and July 2025 at the LUMC receiving a direct oral anticoagulant and were discharged directly from the emergency department. The Hestia criteria were used to select patients for home treatment. RESULTS: A total of 47 patients (38%) with PE were treated at home during the study period. The survey was sent out to the 32 eligible patients and 30 completed the survey (94%). Nineteen (63%) patients were male, their mean age was 66 years [52-74], 50% had a prior venous thromboembolism, one had active cancer and 53% had segmental PE. Overall patient satisfaction was good: 28 out of 30 (93%) indicated to be satisfied or very satisfied with the delivered care, and 28 patients (93%) would prefer home treatment again if PE was to recur. Nevertheless, 5 out of 30 (17%) reported to have experienced any degree of anxiety due to the home treatment. CONCLUSION: Our study shows that patient satisfaction with home treatment is high and that the majority of those treated at home would prefer this over admission, demonstrating that avoiding hospitalization is not only cost-efficient but also associated with positive patient experiences.