A cohort study: Video consultation on preterm neurodevelopmental follow-up care during the COVID-19 pandemic - opportunities and challenges

JMIR Pediatr Parent. 2022 Nov 17. doi: 10.2196/40940. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, parents of very preterm and "at risk" born infants were exceptionally worried of being infected. The only mean of protection during the onset of the pandemic was social distancing. Video consultations for neurodevelopmental follow-up care were offered as an alternative way to stay in contact with patients and their families, to provide qualified support and to monitor and assess the child's development.

OBJECTIVE: To assess the feasibility of this method and family satisfaction, an interview was conducted after video and an in-person consultation.

METHODS: An interview containing 28 questions was created to evaluate parental satisfaction, for example, confidentiality, children's behavior during consultation. A total of 93 interviews with parents were conducted and compared (58 after a video and 35 after in person consultation). Interviews were conducted at the end of the consultation by a trained professional between March 2020 and February 2021. The video consultation was conducted using the certified platform by Zava Sprechstunde Online GmbH® maintaining data protection by an end-to-end-encryption. Follow-up consultations (via video and in-person) were performed at a corrected age of 3, 6 and 12 months as well as 2, 3, 4 and 5 years. The rate of total follow-up appointments attended during the survey period within the COVID-19 pandemic was evaluated and compared with the previous year.

RESULTS: There were no significant differences between video and in-person consultation groups in satisfaction, confidentiality of the consultation and discussion of private and sensitive information. Following video consultation, parents shared significantly their avoidance to contact medical professionals more often (P = .045; W = 1094.5, d = -0.1782146, n=93) than the in-person consultation group. Parents of the video consultation group stated that performing a guided examination on their child as comfortable and helpful in understanding their child's development. In fact, they agreed to take advantage of a future video consultation. The rate of total follow-up appointments compared to the previous year's rate even increased. Between March 2019 and February 2020, 782 out of 984 (79.5%) children born at Essen University Hospital attended a follow-up appointment. During the survey period between March 2020 and February 2021, a total of 788 out of 1086 children (73%) attended a follow-up appointment, 14.9% were video consultations.

CONCLUSIONS: The feasibility and parental satisfaction attending video consultation for follow-up care of their very preterm or at risk-born infant was as high as in-person consultation. Parents rated video consultations as confidential as in-person appointments. Telemedicine can be offered as an equivalent alternative to an in-person consultation and is particularly useful under certain circumstances i.e. for very sick children who require assistive devices, e.g. respiratory support and oxygen or for those living long distances.

PMID:36409307 | DOI:10.2196/40940