Factors associated with caregiver adherence to mobile health interstage home monitoring in infants with single ventricle or biventricular shunt-dependent heart disease

Jackson, Sydney R; Chowdhury, Shahryar M; Woodard, Frances K; Zyblewski, Sinai C.

doi:10.1017/s1047951122001822

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…To date, there is not a recommended level of adherence for monitoring of infants with SV heart disease; however, the degree of adherence in our study aligns with prior studies. 27 , 28 Jackson et al 28 reviewed adherence with mobile health monitoring of infants with SV heart disease at their institution during the interstage period. They defined high adherence as >50%, which was achieved in only 61% of their cohort, and found no association with adherence and interstage death.…”

Section: Discussionmentioning

confidence: 99%

Association Between Remote Monitoring and Interstage Morbidity and Death in Patients With Single‐Ventricle Heart Disease Across Socioeconomic Groups

Cherestal,

Erickson,

Noel‐MacDonnell

et al. 2023

JAHA

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Background Despite improvements in survival over time, the mortality rate for infants with single‐ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES. Methods and Results Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near‐instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the basis of 6 variables relating to SES. Hierarchical logistic regression, adjusted for potential confounding characteristics, was used to determine the association between SES and death or transplant listing during the interstage period. Of 610 infants, 39 (6.4%) died or were listed for transplant. In unadjusted analysis, the rate of reaching the primary outcome between SES tertiles was similar ( P =0.24). Even after multivariable adjustment, the odds of death or transplant listing were no different for those in the middle (odds ratio, 1.7 [95% CI, 0.73–3.94) or highest (odds ratio, 0.997 [95% CI, 0.30, 3.36]) SES tertile compared with patients in the lowest (overall P value 0.4). Conclusions In a large multicenter cohort of infants with single‐ventricle heart disease enrolled in a digital remote monitoring program during the interstage period, we found no difference in outcomes based on SES. Our study suggests that this novel technology could help mitigate differences in outcomes for this fragile population of patients.

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Section: Discussionmentioning

confidence: 99%

Association Between Remote Monitoring and Interstage Morbidity and Death in Patients With Single‐Ventricle Heart Disease Across Socioeconomic Groups

Cherestal,

Erickson,

Noel‐MacDonnell

et al. 2023

JAHA

View full text Add to dashboard Cite

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“…A recent study by Jackson et al identified lack of English language fluency, lower median household income, and Medicaid insurance as risk factors for lower caregiver adherence to mobile health interstage home monitoring. 43 Qualitative studies could provide valuable insight into obstacles to adherence and inspire alternative strategies to address disparities. In addition, the discontinuation of home monitoring following S2P marks a major transition point for infants with HLHS.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

Shustak,

Huang,

Tam

et al. 2023

JAHA

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Background Poor interstage weight gain is a risk factor for adverse outcomes in infants with hypoplastic left heart syndrome. We sought to examine the association of neighborhood social vulnerability and interstage weight gain and determine if this association is modified by enrollment in our institution's Infant Single Ventricle Management and Monitoring Program (ISVMP). Methods and Results We performed a retrospective single‐center study of infants with hypoplastic left heart syndrome before (2007–2010) and after (2011–2020) introduction of the ISVMP. The primary outcome was interstage weight gain, and the secondary outcome was interstage growth failure. Multivariable linear and logistic regression models were used to examine the association between the Social Vulnerability Index and the outcomes. We introduced an interaction term into the models to test for effect modification by the ISVMP. We evaluated 217 ISVMP infants and 111 pre‐ISVMP historical controls. The Social Vulnerability Index was associated with interstage growth failure ( P =0.001); however, enrollment in the ISVMP strongly attenuated this association ( P =0.04). Pre‐ISVMP, as well as high‐ and middle‐vulnerability infants gained 4 g/d less and were significantly more likely to experience growth failure than low‐vulnerability infants (high versus low: adjusted odds ratio [aOR], 12.5 [95% CI, 2.5–62.2]; middle versus low: aOR, 7.8 [95% CI, 2.0–31.2]). After the introduction of the ISVMP, outcomes did not differ by Social Vulnerability Index tertile. Infants with middle and high Social Vulnerability Index scores who were enrolled in the ISVMP gained 4 g/d and 2 g/d more, respectively, than pre‐ISVMP controls. Conclusions In infants with hypoplastic left heart syndrome, high social vulnerability is a risk factor for poor interstage weight gain. However, enrollment in the ISVMP significantly reduces growth disparities.

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Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

Shustak¹,

Huang

Tam

et al. 2023

Preprint

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Introduction: Poor interstage (IS) weight gain is a risk factor for adverse outcomes in infants with hypoplastic left heart syndrome (HLHS). We sought to examine the association of neighborhood social vulnerability and IS weight gain and determine if this association is modified by enrollment in our institution's Infant Single Ventricle Management and Monitoring Program (ISVMP). Methods: We performed a retrospective single-center study of infants with HLHS before (2007-2010) and after (2011-2020) the introduction of the ISVMP. The primary outcome was IS weight gain, and the secondary outcome was IS growth failure. Multivariable linear and logistic regression models were used to examine the association between Social Vulnerability Index (SVI) and the outcomes. We introduced an interaction term into the models to test for effect modification by ISVMP. Results: We evaluated 217 ISVMP infants and 111 pre-ISVMP historical controls. SVI was associated with IS growth failure (P = 0.001), however, enrollment in ISVMP strongly attenuated this association (P = 0.04). Pre-ISVMP, high and middle vulnerability infants gained 4 gm/day less and were significantly more likely to experience growth failure than low vulnerability infants (high vs. low: aOR 12.5; 95% CI 2.5-62.2; middle vs. low: aOR 7.8; 95% CI 2.0-31.2). After the introduction of the ISVMP, outcomes did not differ by SVI tertile. Middle and high SVI infants enrolled in ISVMP gained 4 gm/day and 2 gm/day more, respectively, than pre-ISVMP controls. Conclusion: In infants with HLHS, high social vulnerability is a risk factor for poor IS weight gain. However, enrollment in ISVMP significantly reduces growth disparities.

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Factors associated with caregiver adherence to mobile health interstage home monitoring in infants with single ventricle or biventricular shunt-dependent heart disease

Cited by 3 publications

References 16 publications

Association Between Remote Monitoring and Interstage Morbidity and Death in Patients With Single‐Ventricle Heart Disease Across Socioeconomic Groups

Association Between Remote Monitoring and Interstage Morbidity and Death in Patients With Single‐Ventricle Heart Disease Across Socioeconomic Groups

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

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