61 - Can adherence to telehealth visit within five days of discharge from the NICU predict compliance with developmental follow-up at one year for very preterm infants?

Publication Number: 4060.61

Alyson N. Brown, Cleveland Clinic Children's, Cleveland Heights, OH, United States; Maitri Shah, Cleveland Clinic Children's, Cleveland, OH, United States; Emman Dabaja, Cleveland Clinic Children's, Cleveland, OH, United States; Ajith Mathew, Cleveland Clinic Children's, Cleveland, OH, United States; Amanda Smith, Cleveland Clinic Children's, Medina, OH, United States; Erin Sweigart, Cleveland Clinic Children's, Cleveland, OH, United States; Lauren Singley, Cleveland Clinic Children's, Akron, OH, United States; HANY ALY, Cleveland Clinic Children's Hospital, Cleveland, OH, United States; Anirudha Das, Cleveland Clinic Children's, Lakewood, OH, United States

Background: Neuro-developmental follow-up of premature infants after discharge from the NICU is essential for early intervention; however, compliance with testing is low, at approximately 50-60% in our clinic. We initiated a telehealth follow-up visit within 5 days of discharge, conducted by the NICU team as part of the transition of care for all infants discharged from the NICU, six years ago, with the goal of establishing a relationship with the dyads to improve compliance with future visits. We sought to establish an association between adherence to the virtual transition of care visits and developmental testing attendance at one year of age in very preterm infants.

Objective: To determine whether compliance with virtual transition of care follow-up of very preterm infants post-NICU discharge predicts adherence to the Bayley Scales of Infant and Toddler Development (BSID IV) testing visit at one year.

Design/Methods: In this retrospective cohort study, we included infants born at less than 32 weeks' gestation who were eligible for BSID-4 testing at one year of age and were discharged from a large tertiary care NICU. The dyads were divided into two groups: those compliant with their telehealth appointment within 5 days of discharge (Group A) and those who did not attend their telehealth appointment (Group B). Analyses were conducted using JMP Student Edition 18, using Chi-square tests for categorical data, Wilcoxon rank-sum tests for continuous nonparametric data, and logistic regression for predictive modeling.

Results: A total of 432 mother/baby dyads met the study criteria. Significantly more (72.4%) infants in Group A (who also showed up for post-discharge visit) completed their BSID-4 testing, while only 58.4% completed BSID-4 in Group B (p=0.0035). Maternal age, percentage married, infant birth weight, maternal drug screen positivity, gravida, and African-American ethnicity were significantly lower in Group B (those who did not attend telehealth follow-up) (Table 1). After adjusting for birth weight, infants who attended a post-NICU telehealth visit were more likely to attend 1-year Bayley follow-up (OR 1.87, 95% CI 1.22-2.86, p = 0.004), while infants that did not were significantly less likely to have a 1-year Bayley done (OR 0.53, 95% CI 0.35-0.82, p=0.004).

Conclusion(s): We utilized information of adherence to post-discharge virtual follow up of dyads to predict completion of the Bayley developmental testing at one year which may help us allocate resources to support parents who did not show at their telehealth visit and improve our clinic's developmental testing completion rates.

Table 1
Demographic differences between Groups A and B, mother/baby dyads that attended a follow-up telehealth visit and those that did not.

Figure 1
Completion of Bayley testing based on post-discharge telehealth visit attendance