Home-based monitoring for the early detection of severe neutropenia in patients receiving chemotherapy to enable intervention and avoidance of adverse events.

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This SBRI Phase II proposal is to establish the necessary knowledge from the planned clinical studies and economic modelling to prove that an innovative technology: home tele-monitoring using white blood cell (WBC) count point of care technology (POCT) can help improve the care pathway and patient experience of people with cancer patients on chemotherapy.A large number of cancer patients on chemotherapy will potentially suffer from adverse events that can lead to delayed courses of therapy, affecting their potential success of cancer treatment. The most serious adverse event relates to a chemotherapy-induced low WBC count termed neutropenia; neutrophils being the major class of white blood cells involved in the human body’s immune defence system. At worst this can lead to emergency hospital admission due to life threatening infections (febrile neutropenia: FN) and require hospital admissions and multiple intravenous antibiotic treatments. These adverse events often occur whilst patients are at home between their multiple courses of chemotherapy. The oncology team managing these patients may be unaware of these adverse events until either: (a) the patient presents for their next course of chemotherapy and their WBC count is too low (neutropenia) for their next round of chemotherapy, so a wasted patient journey and a loss of valuable clinic treatment time; or (b) they are rushed into hospital with life threatening infections with subsequent hospitalisation, which might have been avoided with earlier intervention.The aim is to develop a home-use tele-monitoring system for measuring WBC count in a finger prick of blood, plus the patient’s temperature. These are the key parameters (alongside observations of signs and symptoms) used by the oncology team to monitor the side effects of chemotherapy. This monitoring system will be coupled to a tele-communications device in the patient’s home, linked with clinically-managed decision support, to enable the oncology team to remotely monitor their cancer patients’ WBC count and temperature, with the potential to ameliorate any adverse events with appropriate interventions. A low WBC count could trigger a re-schedule of the next chemotherapy clinic (so saving patient's and clinician's time and optimising out-patients clinic utilisation) or be managed by blood transfusions or administering growth factors to promote white cell production. Earlier monitoring of WBC count and temperature could help indicate the onset of neutropenia, with the risk of progression to FN, which could be managed proactively with growth factors and antibiotics.The benefits of this novel combination of technologies will be substantial to patients, the healthcare system and clinicians, including: increased convenience, improved patient outcomes through more optimised use of chemotherapy and drug treatments, reducing unnecessary journeys for the patient and more efficient utilisation of the limited healthcare resource.