Daily Symptom Home Monitoring Decreases Hospital Readmissions in Children and Young Adults With Acute Lymphoblastic Leukemia.

[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.