At-Home Monitoring for Chemotherapy | The Future Today
Expedited Time-to-Treatment & Dose-Adjustment by Athelas Finger-Stick
Managing the side-effects of chemotherapy and associated risk of infection is fraught with uncertainty for patients and clinical outcome — at Athelas, we understand and we‘re working hard to fix this.
We’ve added features, in review, to our digital health platform for:
- Early discovery of neutropenic infection and rapid opening of robust care pathways for solid tumor patients, as opposed to variable presentation at emergency triage.
- Streamlined patient monitoring of Chronic Myeloid Leukemia (CML) by shifting onsite clinical monitoring to the home for convenience and remote dose adjustment.
Note: Athelas is awaiting a home-use designation from the FDA, enabling full at-home self testing by patients. It is currently cleared for point-of-care indications.
In consideration is our FDA & Health Canada-cleared breakthrough — finger-stick white blood cell differential — complimented with inflammation monitoring by platelet count and your blood pressure, pulse oximeter, thermometer, and glucometer data.
If you’re a clinician or researcher interested in grants to conduct pioneering prospective research to improve the quality of infection and early-sepsis screening, we’d love to collaborate to improve patient outcomes.
If you’re a patient receiving therapy for a solid tumor or Chronic Myeloid Leukemia we’d love to hear your story. Below you’ll read Nick’s story — a case of how clinical assumptions can lead to adverse events.
Nick’s Story | When Clinical Assumptions Create Complications
Scenario
A day like any other, Nick, a middle-aged small business owner, attends his chemotherapy appointment for coloretal cancer with his wife Margaret. Nick is mid-cycle in a 4 month chemotherapy cycle, receiving eight doses of FOLFOX every second week from an outpatient center in Washington state. On return from his chemotherapy, everything begins to change: sweating and chills turns to a shiver-fit and then he collapses — Nick is comatose. Paramedics are called by Margaret, who informs them of Nick’s medical history and his vitals: temperature of 103.3℉ and systolic blood pressure of 52 mmHg — Nick is in septic shock. Margaret, an oncology nurse herself, is keen to identify Nick’s low white blood cell (WBC) count three-days prior and confirms to paramedics that no additional screening bloodwork was done this day — Nick was presumed to have rebounded blood counts. Nick and Margaret are separated due to COVID-19 protocols and Nick is rushed to hospital.
All names have been changed for patient privacy
Intervention
On triage at the local hospital, Nick is presumed to have COVID-19, x-rays are performed, and containment measures are undertaken. On later presentation of Nick’s oncologist, Dr. Waggner, steroids are administered to counter the cytokine storm. After COVID results are returned negative, broad-spectrum i.v. antibiotics are administered in the hospital ICU for the proceeding 5-days and Nick begins to stabilize and regain consciousness. Eventually Nick is transferred to a recovery ward for a two-week stay.
As a lasting implication of febrile neutropenia, Nick’s chemotherapy is now augmented with steriods to control cytokine release and prevent recurrence. The challenge for Nick is that as a diabetic, steroid therapy makes it very hard for him to control his blood sugar and he complains of the psychological effects of the medication. Nick must also now spend 6 hours at the outpatient chemotherapy center after his regular dosage and he is monitored closely with clinical follow-up calls for an additional 46-hours at home. Prior to this adverse event, Nick would spend two hours at clinical site as the only interaction with the center.
The Problem: Clinical Assumptions & Long-Cycle Data
- Despite a low WBC count from lab work completed three days prior to the chemotherapy appointment, Nick’s oncologist made an assumption that his counts would rebound and decided not to retest on the day of therapy.
- Nick was not screened for inflammation at the chemotherapy appointment, which contributed to a later incorrect presumption of aggressive COVID-19.
- Without the quick intervention of Nick’s wife to call an ambulance and provide medical history, the rapid progression of sepsis would undoubtedly resulted in a much worse outcome. The attending paramedic indicated Nick was within two hours of passing.
The Athelas Solution
- Preventative At-home Monitoring: White blood cell differential, platelets, and inflammation (infection) markers are mapped daily over course of chemotherapy by finger-stick. No assumptions necessary.
- Point-of-Care Screening Confirmation: a 90-second screening confirmation (same as above) by the attending nurse at appointment.
- Adverse Event Pathway Creation: Patient trend information generates automated flagging for the oncologist to plan interventions including at-home antibiotic use in mild cases or direct hospital admission. In unplanned emergencies, Athelas can generate a clinical report with instructions on how to classify and prioritize care based on international guidelines. A device that acts as a patient advocate, insurance for when you are at-risk.
Thanks to the dream team: James Lucarotti, Andrew Roberts, & Kat Fowler for bringing this to life.
