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Scheduled follow-up following hospitalization for bronchiolitis is typical care, but a new report questions whether as-needed care can be just as effective.
A follow-up visit after hospitalization for bronchiolitis is a typical course of action, frequently because parents appreciate the assurance that a scheduled visit can provide. However, a report in JAMA Pediatrics looks at whether an as-needed follow-up visit can work just as well as the typical scheduled visit.1
Investigators ran an open-label noninferiority randomized clinical trial that ran from January 2018 to April 2019. The study assessed children aged younger than 24 months who had been hospitalized for bronchiolitis at either a children’s hospital (Primary Children’s Hospital, Salt Lake City, Utah, and Lucile Packard Children’s Hospital, Palo Alto, California) or a community hospital (Intermountain Riverton Hospital, Riverton, Utah, and Packard El Camino Hospital, Mountain View, California). Parental anxiety at 7 days postdischarge, as measured by the Hospital Anxiety and Depression Scale, was the primary outcome.
There were 304 children included in the study and the primary outcome was available for 269 patients. One hundred and six children in the scheduled follow-up group went to a scheduled posthospitalization visit where 26 children in the as-needed group had such a visit. The average 7-day parental anxiety score was 4.2 among parents with a scheduled visit and 3.9 among parents with as-needed visits. Other than the decreased average number of clinic visits in the as-needed group, no significant difference was seen between the groups in the secondary outcomes, which included symptom duration and hospital readmission.
The researchers concluded that as-needed follow-up visits were noninferior to scheduled follow-up visits when it came to reducing parental anxiety. They believe that their findings show that as-needed follow-up care for bronchiolitis can be an effective strategy for posthospital care.
1. Coon ER, Destino LA, Greene TH, Vukin E, Stoddard G, Schroeder AR. Comparison of as-needed and scheduled posthospitalization follow-up for children hospitalized for bronchiolitis. JAMA Pediatr. July 6, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.1937