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- Pettersson, Miriam, 1977-, et al.
(författare)
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Home phototherapy for hyperbilirubinemia in neonates : an unblinded multicentre randomised controlled trial
- 2023
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Ingår i: Örebro University's Nobel Day Festivities. - 9789187789922
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Konferensbidrag (refereegranskat)abstract
- Background/Objective: The aim of this study was to assess whether home phototherapy is a safe alternative to hospital treatment.Method: This was a randomised controlled, multicentre, trial in which term newborns with a total serum bilirubin of 300-400 μmol/ were randomized to either home phototherapy or conventional in-hospital phototherapy.The outcome measurements were parent-infant bonding, stress and measurements of safety and feasibility. A descriptive qualitative study based on interviews was performed as well as a health economic analysis.Result: 147 patients were recruited from 6 hospitals, Results showed no difference between groups in the safety and feasibility outcomes. Parents in the intervention group had better scores on bonding and lower levels of stress. The interviews showed that parents felt secure at home. The cost per patient was €337 for home phototherapy compared with €1156 for the hospital alternative indicating average cost savings of €819 or 71% per patient.Conclusion: Home phototherapy can be considered a safe and feasible alternative to hospital care for well selected patients. It improves bonding and stress for parents and reduces health care costs. Since the first publication from this study was published home phototherapy is now recommended by the American Academy of Pediatrics as an alternative to hospital care for patients with uncomplicated hyperbilirubinemia.
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- Pettersson, Miriam, 1977-, et al.
(författare)
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Home phototherapy of term neonates improves parental bonding and stress : findings from a randomised controlled trial
- 2022
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 111:4, s. 760-766
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Tidskriftsartikel (refereegranskat)abstract
- AIM: We aimed to evaluate whether in-home phototherapy for hyper bilirubinaemia could reduce the poorer parent-infant bonding and increased parental stress associated with neonatal hospital treatment.METHODS: In this multicentre randomised controlled trial we allocated families to either home phototherapy or standard hospital care. The primary outcome was parent-infant bonding measured on the Postpartum Bonding Questionnaire directly after therapy and 4 months later. Secondary outcomes were results on four other instruments measuring parental bonding, quality of life, and mental health.RESULTS: We randomised 78 of 147 newborn infants to intervention and 69 to the control group. No significant differences were detected in length of stay, mean bilirubin, or weight gain. Parents in the intervention group had better scores on bonding both at discharge (p = 0.034) and at 4 months (p = 0.008; effect size r = 0.2) and lower levels of stress at 4 months (p = 0.024) than controls. No statistically significant outcomes were found for the secondary outcomes.CONCLUSION: In-home phototherapy improved bonding and reduced parental stress in comparison with usual in-hospital treatment. Caregivers should consider offering home phototherapy to families of non-immunised term infants with hyperbilirubinaemia.
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