Home-based phototherapy for neonatal hyperbilirubinemia: A one-time Canadian Paediatric Surveillance Program Survey.

Objectives: Home-based phototherapy (HP) has gained traction as an alternative to hospital-based treatment for neonatal hyperbilirubinemia, but the safety of this practice remains unclear. This study aimed to identify adverse events (AEs) associated with HP in Canada.

Methods: A one-time survey, distributed through the Canadian Paediatric Surveillance Program, collected retrospective data from paediatricians. The survey included questions about the use of HP, AEs associated with HP, potential HP AE risk factors, and outcomes. A descriptive statistical analysis was conducted.

Results: The survey response rate was 31% (844/2741), with 497 respondents indicating that they provide care for neonatal hyperbilirubinemia. Among those 497 respondents, 58 (12%) reported working at a centre that provides HP. AEs were reported by 15 (3%) physicians with 21 cases of AEs associated with HP in the preceding 12 months. Most AEs resulted in admissions or readmissions to the hospital for inpatient phototherapy. No serious AEs or long-term consequences were reported. Risk factors were identified in 67% of cases, with infant-related factors identified more frequently than provider, system, or family-related factors. Formal protocols for patient assessment and follow-up were in place at most centres that provide HP.

Conclusion: This survey revealed no serious AEs related to HP, as reported by paediatricians in Canada, in the preceding 12 months. The survey also revealed that while HP is available in Canada, there is limited access and a lack of standardization to its administration. This study provides valuable insights into the safety and practice of HP for neonatal hyperbilirubinemia in Canada.