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Prospective study of a web-mediated management of febrile neutropenia related to chemotherapy (Bioconnect)

  • Fabrice Denis
  • Eric Voog
  • Yoann Pointreau
  • Hugues Bourgeois
  • Valérie Seegers
  • Katell Le Du
Original Article

Abstract

Background

We aimed to investigate whether patient self-evaluated symptoms transmitted via Internet is feasible between planned visits to provide an early management of fever and neutropenia induced by chemotherapy, and if it can reduce hospitalizations for severe neutropenia.

Methods

Patients who received a chemotherapy regimen with an overall risk of febrile neutropenia ≥ 20% had to report daily temperature between physician planned visits using a web application. Fever and clinical signs of seriousness were reported to the physician (if some criteria were fulfilled in a specific algorithm) via automatic email notifications by the web application. Patients could be hospitalized quickly or could take over at home, make blood count, and take predefined oral antibiotics if indicated. Primary outcome was patient’s compliance and satisfaction. The number and the cost of hospitalization were also assessed and compared with an historical cohort of patients with similar clinical conditions and treatment.

Results

Among the 41 patients included, 36 (87.8%) used the web application with 88% of daily compliance and 90% (28/33) of satisfaction. One patient (2.7%) had planned hospitalization after the web application alert. In the historical cohort, the rate of unplanned hospitalization for febrile neutropenia was 17% (6 patients) and 2.7% (1 patient) in users of the web application cohort. The cumulative cost of hospitalization for neutropenia was USD 28,827 in the historical cohort and USD 6563 in the web application cohort.

Conclusion

Web-mediated follow-up of febrile neutropenia is feasible. It led to high patient satisfaction, high compliance, and a possible reduction of the number and the cost of hospitalizations.

Keywords

e-health Neutropenia Chemotherapy Clinical trial 

Notes

Acknowledgements

We thank the patients and their families for their participation in this study, as well as investigators, promotor: Integrated Center for Oncology (ICO, Angers, France), Anne-Lise Septans for statistical analysis, Magali Balavoine for trial monitoring, and sponsors: CHUGAI PHARMA France and SIVAN Innovation Ltd. for financial sponsorship.

Fundings

This work was supported by CHUGAI PHARMA France and SIVAN Innovation Ltd.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institut Inter-régional de Cancérologie Jean BernardLe MansFrance
  2. 2.CORIA UMR 6614—Normandie UniversitéCNRS – Université et INSA de RouenSaint-Étienne-du-RouvrayFrance
  3. 3.Institut de Cancérologie de l’Ouest Paul PapinAngersFrance

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