ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021
Home-based care of low-risk febrile neutropenia in children-an implementation study in a tertiary paediatric hospital.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Guideline
- Procalcitonin and Interleukin-10 May Assist in Early Prediction of Bacteraemia in Children With Cancer and Febrile Neutropenia.Frontiers in immunology · 2021Trial
- "Doing everything we can": parents' strategies for managing chemotherapy-related symptoms in children with leukemia at home.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Pediatric outpatient parenteral antibiotic therapy: an important option for pediatric hospitals in Germany.GMS hygiene and infection control · 2026Article
- Impact of time to antibiotics on clinical outcome in paediatric febrile neutropenia: a target trial emulation of 1685 episodes.The Lancet regional health. Western Pacific · 2024Article
- "Better at home": Mixed methods report of intricacies in pediatric febrile neutropenia management.Cancer medicine · 2024Article
- Can I go home now? The safety and efficacy of a new UK paediatric febrile neutropenia protocol for risk-stratified early discharge on oral antibiotics.Archives of disease in childhood · 2023Article
- Blood transcriptomics identifies immune signatures indicative of infectious complications in childhood cancer patients with febrile neutropenia.Clinical & translational immunology · 2022Article
- Examining health-related quality of life in pediatric cancer patients with febrile neutropenia: Factors predicting poor recovery in children and their parents.EClinicalMedicine · 2021Article
- Managing low-risk febrile neutropenia in children in the time of COVID-19: What matters to parents and clinicians.Journal of paediatrics and child health · 2021Article
- Optimising Antimicrobial Selection and Duration in the Treatment of Febrile Neutropenia in Children.Infection and drug resistance · 2021Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundHome-based management of low-risk febrile neutropenia (FN) is safe, improves quality of life and reduces healthcare expenditure. A formal low-risk paediatric program has not been implemented in Australia. We aimed to describe the implementation process and evaluate the clinical impact.
methodThis prospective study incorporated three phases: implementation, intervention and evaluation. A low-risk FN implementation toolkit was developed, including a care-pathway, patient information, home-based assessment and educational resources. The program had executive-level endorsement, a multidisciplinary committee and a nurse specialist. Children with cancer and low-risk FN were eligible to be transferred home with a nurse visiting daily after an overnight period of observation for intravenous antibiotics. Low-risk patients were identified using a validated decision rule, and suitability for home-based care was determined using disease, chemotherapy and patient-level criteria. Plan-Do-Study-Act methodology was used to evaluate clinical impact and safety.
resultsOver 18 months, 292 children with FN were screened: 132 (45%) were low-risk and 63 (22%) were transferred to home-based care. Compared with pre-implementation there was a significant reduction in in-hospital median LOS (4.0 to 1.5 days, p < 0.001) and 291 in-hospital bed days were saved. Eight (13%) patients needed readmission and there were no adverse outcomes. A key barrier was timely screening of all patients and program improvements, including utilising the electronic medical record for patient identification, are planned.
conclusionThis program significantly reduces in-hospital LOS for children with low-risk FN. Ongoing evaluation will inform sustainability, identify areas for improvement and support national scale-up of the program.
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