This study evaluates the value of routine follow-up with a child's pediatrician after hospitalization for bronchiolitis. Parents of half of participants will be instructed to follow-up with the child's pediatrician regardless of symptom resolution, while the other half will be instructed to follow-up on an as-needed basis (only if the child worsens, doesn't improve, or other concerns develop).
Bronchiolitis is highly prevalent and burdensome among children less than 2 years of age. For this reason, many therapies have been tried by providers and studied by researchers. Unfortunately, interventions have largely been shown to be ineffective, prompting campaigns to reduce use of ineffective therapies. One commonly prescribed but thus far unstudied intervention often provided to children discharged after hospitalization for bronchiolitis is routine follow up with their pediatrician. Whether the costs and time spent for these visits are worthwhile depends on the extent to which the child and the child's parents benefit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
304
Parents of children randomized to scheduled follow up will be instructed to follow up with their primary care physician within 4 days of discharge regardless of improvement and/or symptom resolution. Research coordinators will verify that the child has a scheduled follow up appointment prior to discharge.
At the time of hospital discharge, parents will be instructed that the child does not need to automatically follow up with his/her primary care physician. Rather, the child should follow up on an as needed basis: if the child does not improve or if new concerns arise.
Packard El Camino Hospital
Mountain View, California, United States
Lucile Packard Children's Hospital
Palo Alto, California, United States
Intermountain Riverton Hospital
Riverton, Utah, United States
Primary Children's Hospital
Salt Lake City, Utah, United States
Parental Anxiety
Parental anxiety, as measured by the anxiety portion of the Hospital Anxiety and Depression Scale (HADS), a 0-28 point scale, with higher values representing higher anxiety.
Time frame: Measured at the first data collection phone call (5-9 days following discharge).
Time From Hospital Discharge to Cough Resolution
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Time From Hospital Discharge to Child Reported Back to Normal
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Number of Clinic Visits Prior to Symptom Resolution
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Any Hospital Re-admission Prior to Symptom Resolution
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Any ED Visit Prior to Symptom Resolution
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Number of Missed Work Days
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
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Missed Daycare
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Ambulatory Prescriptions (Albuterol, Antibiotics, Steroids)
Time frame: Measured by parent report via weekly research coordinator phone calls, until symptoms resolved or 50 days after discharge, whichever occurs first.
Ambulatory Testing (i.e. Pulse Oximetry, Chest X-ray)
Time frame: Measured by parent report, at the first data collection phone call (5-9 days following discharge).
Relationship With PCP
Measured by the Patient-Doctor Depth-of-Relationship Scale, 0-32 points, with higher scores indicating a stronger relationship with PCP.
Time frame: Measured by parent report via research coordinator phone call at 1 month from discharge.
Report That Care Was Perfect 1 Month After Discharge
Measured by a question from the Patient Satisfaction Questionnaire Short Form (PSQ-18), those who indicate agree or strongly agree
Time frame: Measured by parent report via research coordinator phone call at 1 month from discharge.
Immunizations Received 1 Month After Discharge
Time frame: Measured by parent report via research coordinator phone call at 1 month from discharge.