Follow-up visits scheduled for younger children who had been hospitalized for bronchiolitis offered reassurance for families, according to recently published study results in JAMA Pediatrics.
“Routine follow-up visits were frequently recommended following bronchiolitis hospitalization, and occurred in approximately two-thirds of patients,” Alan R. Schroeder, MD, of the pediatrics department at Stanford University School of Medicine, and colleagues wrote. “While new visits were uncommonly provided, visits seemed to provide families with reassurance.
“Although generally considered standard practice, the value of routine postdischarge visits has not been rigorously evaluated.”
The researchers conducted a multicenter prospective study of children aged younger than 2 years who were hospitalized with a bronchiolitis diagnosis at five hospitals affiliated with Stanford Children’s Health and Intermountain Healthcare in Utah. Exclusion criteria included congenital heart disease, chronic lung disease, neuromuscular disease, immunodeficiency or malignant neoplasms. Patients who used supplemental oxygen at discharge also were excluded.
To measure the occurrence and outcomes of any health care, and families’ perceptions of the encounters, the researchers contacted families 5 to 8 days after discharge and weekly thereafter until symptoms resolved.
There were 198 families (median child age, 5.4 months; 59% male) who participated in the study, with telephone follow-up completed on 84% of patients.
Among patients contacted within 8 days of discharge, 66% had attended at least one clinic visit. Thirteen of those patients (12%) were provided new prescriptions and three patients (2%) were readmitted to the hospital,
Families reported that office visits were “a good use of their time,” with reassurance provided considered the most valuable asset of the visit (70%). Eleven percent of patients had cough for 2 weeks or more after being discharged.
The data obtained from the study will be used to plan a multicenter, randomized trial comparing scheduled and “as-needed” clinic follow-up visits.
“Similar investigations are needed to analyze follow-up care for other acute conditions (eg, pneumonia, gastroenteritis, skin and soft tissue infections, febrile infant) in children in which disease is self-limited and clinical improvement is expected,” the researchers concluded. “Telephone follow-up or video conferencing are potential alternatives to scheduled follow-up visits. Lack of reimbursement may limit their uptake, but these approaches may provide equivalent family reassurance, education and satisfaction while limiting the risk and costs associated with increased health care exposure.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.