Remote monitoring using virtual wards for the management of febrile neutropenia in patients with solid tumours: a service evaluation
Introduction: Febrile neutropenia (FN) is a serious oncological emergency requiring prompt management. Traditional inpatient care has been the standard approach, but remote virtual wards offer a novel strategy to reduce hospital burden while ensuring patient safety. Aims: This service evaluation aim...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Future Healthcare Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2514664525002085 |
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| Summary: | Introduction: Febrile neutropenia (FN) is a serious oncological emergency requiring prompt management. Traditional inpatient care has been the standard approach, but remote virtual wards offer a novel strategy to reduce hospital burden while ensuring patient safety. Aims: This service evaluation aimed to evaluate the efficacy and safety of a virtual ward model for managing patients with low-risk FN, focusing on hospital stay duration and readmission rates (ie, quality improvement and patient safety) Materials and methods: A retrospective analysis was conducted, comparing patients managed on virtual wards with those receiving traditional inpatient care. Patients were matched based on key clinical characteristics (age, primary cancer site, chemotherapy regimen, and MASCC index),1 and outcomes were assessed, including hospital stay duration and readmission rates. Results and discussion: In total, 30 patients were managed on virtual wards, with a median age of 49 years (interquartile range (IQR): 41.3–63). Among them, 25 (83.3%) were female. The matched inpatient group included 21 patients, with a median age of 52 years (IQR: 40–56). Demographics and disease characteristics are given in Tables 1 and 2, respectively.The average hospital stay before being admitted to virtual wards was 1.2±1.7 days, compared with 4.8±2.5 days for those managed entirely on physical wards before virtual wards were introduced. Patients remained on remote monitoring for an average of 5.3±2.1 days. Only one patient (3.3%) was readmitted to the hospital from the virtual ward within the same chemotherapy cycle, with neutropenia/infection-related issues. By comparison, there were no re-admissions for physical ward patients. On virtual wards, 36.7% patients had Grade 3 and 63.3% had Grade 4 neutropenia.To our knowledge, no study has compared the management of FN in virtual wards versus physical wards. Existing literature on remote monitoring for FN is limited. The DEFeNDR program in the USA reported improved outcomes with remote monitoring for patients with FN, but its small sample size and non-randomised design limit its generalisability.2 Studies relating to other medical conditions managed on virtual wards have shown shorter hospital stays with variable rates of re-admissions.3–6 Conclusion: Virtual wards represent a feasible approach for managing low-risk FN, offering reduced hospital stays with close monitoring. Although a low readmission rate shows that they are safe, optimising patient selection and refining protocols remain critical to further improve patient safety. Further large-scale studies are needed to validate these findings and assess their cost-effectiveness. |
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| ISSN: | 2514-6645 |