Feasibility of Video Consultation for Preterm Neurodevelopmental Follow-up Care During the COVID-19 Pandemic: Cohort Study

Abstract

Background During the COVID-19 pandemic, parents of infants born very preterm or at risk were exceptionally worried about being infected. The only means 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 expert support, and to monitor and assess children’s development. Objective To assess the feasibility of and family satisfaction with video consultations, interviews were conducted after video and in-person consultations. Methods An interview with 28 questions was created to evaluate parental satisfaction with the consultations (eg, their confidentiality and the children’s behavior). A total of 93 interviews with parents were conducted between March 2020 and February 2021 and compared (58 after video consultations and 35 after in-person consultations). The interviews were conducted at the end of the consultations by a trained professional. The video consultations were conducted using a certified platform created by Zava Sprechstunde Online, maintaining data protection with end-to-end encryption. Follow-up consultations (video or in-person) were performed at corrected ages 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 was evaluated and compared with the previous year. Results There were no significant differences between the video and in-person consultation groups in satisfaction, attitudes on the confidentiality of the consultation, or discussion of private and sensitive information. Following video consultations, parents were significantly more likely to report that they were avoiding contact with medical professionals during the pandemic (P=.045; Shapiro-Wilk W=1094.5, Cohen d=–0.1782146) than the in-person consultation group. Parents in the video-consultation group stated that performing a guided examination on their child was comfortable and helped them understand their child’s development. In fact, they agreed to take advantage of future video consultations. The rate of total follow-up appointments increased compared to the previous year. Between March 2019 and February 2020, 782 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 of 1086 children (73%) attended a follow-up appointment, of which 117 (14.9%) were video consultations. Conclusions The feasibility of attending video consultations for follow-up care of very preterm or at-risk infants and parental satisfaction with these consultations were as high as for in-person consultations. Parents rated video consultations as being as confidential as in-person appointments. Telemedicine can be offered as an equivalent alternative to in-person consultations and is particularly useful under certain circumstances, such as for very sick children who require assistive devices or respiratory support and oxygen or for those living a long distance away.

Envisioning post pandemic digital social medical aftercare – opportunities and challenges

“…Self-assessment of their child empowered parents and gave them a better understanding of their child's neurodevelopment. They also addressed common screening questions and day-to-day concerns about weight gain, feeding, developmental milestones, and self-regulation (11,12). In line with these results According to Das et al, telemedicine is a viable tool for follow-up care (13).…”

“…Video consultations were also feasible and showed some bene ts for parents in developmental neurological follow-up. Albayrak et al have shown that the neurodevelopmental status of an infant and a child is surprisingly easy to access (11,12). Self-assessment of their child empowered parents and gave them a better understanding of their child's neurodevelopment.…”

“…Video consultations have many other advantages over telephone calls (3,12): They allow health professionals to gain a better insight into the family and home environment, enabling them to provide personalized guidance, competent counselling and safe networking where needed (11,12). To observe parent-child interaction and to identify any special needs or strains on families is crucial for SMN (17)(18)(19).…”

Virtual Visits for Developmental Screening in High-Risk Infants

“… 11,15 Virtual visits may be more convenient for parents of infants who are medically fragile and require additional equipment such as oxygen. 16 For premature infants at increased risk of infection, having a virtual visit may help to limit their exposure to viral illnesses. 16 Importantly, provision of valuable therapies to high-risk infants was not delayed.…”

“… 16 For premature infants at increased risk of infection, having a virtual visit may help to limit their exposure to viral illnesses. 16 Importantly, provision of valuable therapies to high-risk infants was not delayed.…”