Daily Symptom Home Monitoring Decreases Hospital Readmissions in Children and Young Adults With Acute Lymphoblastic
Rotem Fishel Ben-Kenan1, Laura L Retson1,2, Briana Fodor3
1Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, Arizona, USA.
Insights
Daily symptom monitoring via text messages for pediatric Acute Lymphoblastic Leukemia patients significantly reduced hospital readmissions. This intervention allowed for timely nursing care, improving patient outcomes without increasing caregiver distress.
Area of Science:
- Pediatric Oncology
- Hematology
- Digital Health
Background:
- Acute Lymphoblastic Leukemia (ALL) treatments improve survival but cause significant morbidity.
- Effective management of treatment-related complications is crucial for pediatric ALL patients.
Purpose of the Study:
- To evaluate if daily symptom home monitoring with targeted nursing intervention reduces readmission rates in newly diagnosed pediatric and adolescent young adults with ALL.
Main Methods:
- A daily symptom survey was texted to participants undergoing initial ALL chemotherapy.
- Nurse clinicians monitored responses and intervened as needed.
- Readmission rates and days at home were compared to a control group.
Main Results:
- The intervention group had significantly lower readmission rates (82.8% vs 55.6%, p=0.028).
- Patients in the intervention group spent more days at home (18.7 vs 16.4 days).
- No significant differences in demographics or caregiver distress were observed.
Conclusions:
- Daily symptom home monitoring and targeted nursing intervention effectively decreased ALL patient readmissions.
- This approach facilitates timely interventions for patient morbidities.
- The strategy improved patient outcomes without increasing caregiver distress.
Objective:
Advancements in treatment of Acute Lymphoblastic Leukemia have led to high overall survival rates but are accompanied by significant treatment-related morbidity and mortality. We aimed to determine whether daily symptom home monitoring paired with targeted nursing intervention decreased readmission rates in newly diagnosed pediatric and adolescent young adults with Acute Lymphoblastic Leukemia at a single large pediatric oncology center.
Methods:
A daily symptom home monitoring survey was texted to families' cellular phones of patients undergoing the initial chemotherapy block (Induction) for Acute Lymphoblastic Leukemia, and responses were monitored and intervened on by nurse clinicians. Control families did not receive daily symptom home monitoring surveys. Readmission rates, total days at home, patient symptoms, and quality of life measures were assessed in both control and participant groups.
Results:
Eighteen control patients and 58 participants were enrolled. Among the patients in the intervention group, 48 patients (82.8%) were not readmitted vs. 10 patients (55.6%) in the control group (p = 0.028). Patients in the intervention group spent 18.7 days at home versus patients in the control group spent 16.4 days at home (p = 0.112). Patient demographics and caregiver distress measures did not significantly differ between the two groups.
Conclusions:
Implementation of a daily symptom home monitoring texted survey aimed at identifying and responding to patients' morbidities allowed for timely intervention and significantly decreased readmission rates without worsening caregiver distress.
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