Home phototherapy for neonatal hyperbilirubinemia: current practices and attitudes

Background

Neonatal hyperbilirubinemia is a leading cause of hospitalization during the first week of life. Recent research suggest that phototherapy, the standard treatment, can be safely and effectively administered at home. Some Dutch hospitals have already adopted home-based phototherapy. The TREAT Jaundice@home study aims to contribute to its broader implementation across the Netherlands. Understanding the perspectives, perceptions, and needs of healthcare professionals is essential for facilitating this implementation.

Methods

This cross-sectional survey targeted pediatricians, midwives, and maternity care assistants with and without prior experience with phototherapy at home. The 82-item questionnaire covered respondent background, experience, interests, motivation, responsibilities, logistics, collaboration, knowledge, indications and contraindications, financial aspects, and implementation readiness.

Results

The study included responses from 16 pediatricians, 90 community midwives, and 514 maternity care assistants. Findings indicate a positive reception of phototherapy at home, regardless of prior experience. The majority expressed satisfaction, recognized potential benefits, and/or demonstrated a willingness to adopt this innovation. Key challenges identified include the need for information, the lack of guidelines, coordination and collaboration issues, and concerns about financial compensation.

Discussion

Phototherapy at home is well-received by healthcare professionals. Addressing the identified challenges is imperative for successful implementation, ultimately benefiting neonates, their families, and healthcare systems.

Impact

Phototherapy at home is well-received and perceived as beneficial by healthcare professionals with and without prior experience

Key challenges include the need for better knowledge and guidelines, coordination and collaboration issues among healthcare professionals, and concerns about financial compensation

Addressing these challenges through comprehensive information, standardized protocols, improved collaboration, and adequate financial compensation is essential to successfully implement phototherapy at home on a larger scale