Home phototherapy for neonatal jaundice in the UK: a single-centre retrospective service evaluation and parental survey.

ABSTRACT

Background: In the UK setting, where neonatal jaundice treatment is required, it is largely carried out in hospitals. However, it is possible to safely administer home phototherapy (HPT). Objective: To report on our centre's experience of HPT and its potential benefits. Design: Retrospective observational study performed as a service evaluation. Patients Infants ≥35 weeks corrected gestational age with a weight of 2 kg and serum bilirubin ≤50 µmol/L above treatment thresholds. Controls were a matched group of infants who received inpatient phototherapy (IPT). Setting: The catchment area of two neonatal intensive care units, one special care unit and a birth centre at four different hospitals that is covered by a single neonatal community outreach nursing team in Birmingham, UK. Intervention HPT was started either in the community or as a continuation of IPT. Controls received IPT. Main outcome measures: The rate of bilirubin reduction, hospital readmission rates and parental satisfaction. Results: 100 infants received HPT while 50 received IPT. No infant showed a progressive rise of serum bilirubin level while receiving HPT. The rate of bilirubin reduction was similar in both HPT and IPT groups (2.4±1.9 and 2.5±1.6 µmol/L/hour, respectively, MD=-0.1, 95% CI -0.74 to 0.53, p=0.74). Readmission rate was 3% in the HPT group. 97% of parents stated that the overall experience was good and 98% would choose HPT if they had their time all over again. Conclusion: Our programme suggests that HPT for neonatal jaundice can be carried out in a select group of infants. It helps in providing holistic family-centred care and is viewed positively by families.