BACKGROUND: Receiving cancer-directed therapy in the ambulatory care setting allows patients and their families to spend more time at home and reduces the use of acute healthcare services. However, many chemotherapy regimens have traditionally required the patient to be in the inpatient setting because of the complexity of the associated supportive care. One potential component of the supportive care regimen is extended-infusion intravenous fluids.
OBJECTIVE: To quantify the impact on patients who participated in the pediatric oncology clinic home hydration (HH) program.
METHODS: Patients participating in the HH program were identified by review of the electronic medical record. Infusion-related characteristics and patient demographics were retrospectively evaluated. The study included all patients treated in the ambulatory oncology clinic who received the entire course of their cancer-directed therapy and corresponding HH in the outpatient setting.
RESULTS: A total of 40 unique patients participated in the HH program. Altogether, there were 167 new HH starts. The most common reason for requiring HH was for the delivery of mesna and post-mesna fluids to prevent damage associated with the toxic metabolites of cyclophosphamide and ifosfamide (n=111). In all, 357 inpatient hospital days were prevented during the 6-month study period with the use of the HH program. The average length of hospitalization prevented was 2.2 days (range, 1-7 days).
CONCLUSION: The HH program was able to help optimize the resources within a healthcare system by preventing 40 patients from spending 357 nights in the hospital over a 6-month period. Programs such as this may help to improve patients’ quality of life and ease the burden associated with the national decrease in inpatient pediatric beds. Although previous investigations have explored the use of HH in the cancer population, the current study represents a higher impact in patient volume.
KEY WORDS: ambulatory cancer center, chemotherapy, children, delivery of healthcare, home hydration program, mesna, pediatric patients, supportive care
J Hematol Oncol Pharm.
2026;16(5):1-6
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