Exploring Perspectives on Feasibility, Challenges, and Support Needs for Chlorhexidine Gluconate (CHG) Bathing in the Outpatient Setting for Hematopoietic Cell Transplant Recipients: A Qualitative Study.

BACKGROUND: Chlorhexidine gluconate (CHG) bathing is recommended for infection prevention in hematopoietic cell transplantation (HCT) patients. As more centers transition HCT care to outpatient settings, understanding patients' perceptions of CHG bathing feasibility, support needs, and home-based barriers in the home environment is critical to promoting adherence. OBJECTIVE: This study explores HCT patient perceptions regarding feasibility of CHG bathing in the outpatient setting to identify barriers and support needs. STUDY DESIGN: We conducted a qualitative descriptive study with 14 HCT (mean 51±16 years) recipients recruited from an inpatient transplant unit. Semi-structured interviews were conducted via phone, video, or in person within three months post-discharge. A rapid qualitative analysis approach was used to identify key sub-themes related to feasibility, challenges, and needed support. RESULTS: Participants supported the feasibility of CHG bathing in the outpatient setting and were supportive of its continued use post-discharge. Participants sited potential challenges including lack of motivation, home management difficulties, and administration concerns. Participants identified the need for structured reminders and accountability, caregiver support, and clinical follow-up. The importance of education emerged as a salient theme. Suggestions for improving adherence included integrating CHG bathing into daily routines and enhancing patient education. CONCLUSION: While CHG bathing in the outpatient setting is feasible, targeted interventions, such as education, reminders, and caregiver involvement may improve adherence and optimize infection prevention. Findings from this study can inform the application of CHG in the outpatient setting and development of innovative, patient-driven strategies to improve CHG adherence. Future efforts should focus on addressing identified barriers to support successful outpatient implementation.

Duke Scholars

Author Mitchell Eric Horwitz Medicine, Hematologic Malignancies and Cellular Therapy

Author Taewoong Choi Medicine, Hematologic Malignancies and Cellular Therapy

Author Nelson Jen An Chao Medicine, Hematologic Malignancies and Cellular Therapy