ADVANCE

A community-based point of care white cell count device to improve critical care pathways for cancer patients with suspected chemotherapy related neutropenic sepsis: a feasibility study

Background

ADVANCE is a pilot (feasibility) study aimed at improving pathways for cancer patients with sepsis whilst receiving chemotherapy. Patients receiving chemotherapy as a part of their cancer treatment often have a lowered immunity and may be unable to fight off infections. This can mean that they are at risk of serious illness or death. The ability to monitor patients who have received hospital-based chemotherapy in their own home may help more quickly identify those patients at high risk or minimal risk from neutropenic sepsis.

Testing new technology

Following current UK National Institute for Health and Care Excellence (NICE) guidelines, UK cancer centres instruct patients on chemotherapy to take their temperature if they feel unwell, and to report this to the centre as soon as possible. These patients then attend hospital and undergo assessment including a blood test. If their blood test reveals that their anti-infection cells (white cells) are low they will need to stay in hospital to receive antibiotics as a drip treatment. We wish to test whether a new piece of equipment (Sight Diagnostics OLO System), which can perform this blood test within 60 seconds in the laboratory using one drop of blood, can prevent patients from being admitted to hospital unnecessarily by ruling out a low white cell count.

Scope of study

This study will explore:

• the acceptability of using the Sight Diagnostics OLO System to patients and healthcare professionals
• the safety of using this system in the laboratory as an aid to the decision making processes with the medical team
• the overall benefit to patients, including whether this equipment should be considered for routine use in patients receiving chemotherapy, in order to improve patient choice, control and independence in relation to their illness
• the economic impact of this new approach
• how this new approach can be integrated across the UK.

Improving patient outcomes

Ultimately we aim to improve outcomes for patients receiving chemotherapy by:

• preventing wasted journeys, inefficient contacts with the NHS and hospital admissions
• detecting low white blood count early to prevent life threatening complications
• provide reassurance and engagement in the management of patients’ cancer.

Wider potential benefits

The additional benefits to the health service may include:

• avoiding unnecessary assessment of patients with an increased body temperature, but are otherwise well, in hospitals and cancer centres
• identifying patients who need urgent assessment, to improve on delivery times and reduction of risk.

Study team

This study will be conducted by a diverse team of collaborators based in North and South Wales (UK), including:

• The Centre for Trials Research at Cardiff University
• Velindre Cancer Centre (Cardiff) Patient Liaison Group facilitated through the Wales Cancer Research Centre and Tenovus
• Velindre NHS Trust Innovation Group

If the pilot study is a success, we will develop a separately funded, larger clinical trial in which we will explore the use of this equipment and assess the overall benefit to patients as well as the economic impact.