Mai-Britt Hägi-Pedersen1,2, Ram B Dessau3, Annelise Norlyk2, Hristo Stanchev1, Hanne Kronborg2. 1. Department of Paediatrics, Slagelse Hospital, 4200 Slagelse, Denmark. 2. Department of Public Health, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark. 3. Department of Clinical Microbiology, Slagelse Hospital, 4200 Slagelse, Denmark.
Abstract
INTRODUCTION: Early in-home care is increasingly being used in Scandinavian countries for clinically stable premature infants. Due to challenges with travel and hospital resources, alternative ways to support parents during early in-home care are being considered. The aim of this study was to test whether the proportion of mothers exclusively breastfeeding, parental confidence and mother-infant interaction increased after early in-home care with premature infants, and to compare the outcomes of in-home care involving the use of video communication and a mobile application with those of in-home care involving in-hospital consultations. METHODS: This study was conducted in four neonatal wards offering premature infant in-home care in Denmark. Premature infants were randomised using 1:1 block randomisation. During early in-home care, families had planned consultations two to three times a week, during which they received support from nurses: the intervention group had video consultations, while the control group had in-hospital consultations. RESULTS: The proportion of exclusively breastfeeding mothers at discharge was 66.7% in the intervention group vs 66% in the control group and decreased to 49.4% vs 55%, respectively, 1 month after discharge. No significant improvements were found in the intervention group compared with the control group. In the intervention group, some video consultations were changed to telephone consultations due to problems with the video function, or to in-hospital consultations due to infants' requirement for medical services. No significant differences in secondary outcomes were observed. DISCUSSION: The study showed similar breastfeeding proportions at discharge. No unfavourable effects of video consultation compared with in-hospital consultation were found, indicating that video consultation could be a viable option and an important supplement during early in-home care. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02581800.
INTRODUCTION: Early in-home care is increasingly being used in Scandinavian countries for clinically stable premature infants. Due to challenges with travel and hospital resources, alternative ways to support parents during early in-home care are being considered. The aim of this study was to test whether the proportion of mothers exclusively breastfeeding, parental confidence and mother-infant interaction increased after early in-home care with premature infants, and to compare the outcomes of in-home care involving the use of video communication and a mobile application with those of in-home care involving in-hospital consultations. METHODS: This study was conducted in four neonatal wards offering premature infant in-home care in Denmark. Premature infants were randomised using 1:1 block randomisation. During early in-home care, families had planned consultations two to three times a week, during which they received support from nurses: the intervention group had video consultations, while the control group had in-hospital consultations. RESULTS: The proportion of exclusively breastfeeding mothers at discharge was 66.7% in the intervention group vs 66% in the control group and decreased to 49.4% vs 55%, respectively, 1 month after discharge. No significant improvements were found in the intervention group compared with the control group. In the intervention group, some video consultations were changed to telephone consultations due to problems with the video function, or to in-hospital consultations due to infants' requirement for medical services. No significant differences in secondary outcomes were observed. DISCUSSION: The study showed similar breastfeeding proportions at discharge. No unfavourable effects of video consultation compared with in-hospital consultation were found, indicating that video consultation could be a viable option and an important supplement during early in-home care. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02581800.
Entities:
Keywords:
RCT; Telehealth; breastfeeding; discharge; early in-home care; premature infant; video consultations
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Authors: Victoria Hammersley; Eddie Donaghy; Richard Parker; Hannah McNeilly; Helen Atherton; Annemieke Bikker; John Campbell; Brian McKinstry Journal: Br J Gen Pract Date: 2019-08-29 Impact factor: 5.386