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Home phototherapy: use and attitudes among community pediatricians

S B Meropol1, A A Luberti, A R De Jong

  • 1Department of Pediatrics, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA.

Pediatrics
|January 1, 1993
PubMed

Insights

Pediatricians often hospitalize infants for jaundice instead of using home phototherapy (HP). Concerns about parental anxiety, testing, and reimbursement, alongside fears of noncompliance and legal issues, impact HP adoption.

Area of Science:

  • Neonatal Medicine
  • Pediatrics
  • Public Health

Background:

  • Unconjugated hyperbilirubinemia is common in neonates.
  • Hospitalization for phototherapy is frequent, yet home phototherapy (HP) is an alternative.
  • Pediatrician perspectives on HP use are not well-documented.

Purpose of the Study:

  • To investigate pediatricians' concerns and experiences with home phototherapy (HP).
  • To assess adherence to American Academy of Pediatrics (AAP) guidelines for HP candidate selection.
  • To identify barriers and facilitators to HP utilization in neonatal jaundice management.

Main Methods:

  • A questionnaire survey was distributed to 150 pediatricians in the Philadelphia, PA area.
  • Ninety-four questionnaires were returned and analyzed.
  • Detailed questions were posed to both HP users and non-users regarding their practices and concerns.

Main Results:

  • Few pediatricians adhered to AAP guidelines for selecting HP candidates.
  • Commonly cited contraindications like prematurity and blood group incompatibilities were often disregarded by HP users.
  • HP users reported issues including parental anxiety, blood testing challenges, and reimbursement difficulties.
  • Non-users cited concerns about noncompliance, medical-legal issues, and administrative hurdles as reasons for not using HP.

Conclusions:

  • Significant deviations from AAP guidelines exist in HP candidate selection.
  • Pediatrician concerns regarding parental anxiety, logistics, and legal/administrative issues hinder HP adoption.
  • Addressing these concerns may improve the utilization of home phototherapy for neonatal hyperbilirubinemia.

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