The following is a summary of “Adherence with post-hospitalization follow-up after pediatric critical illness due to respiratory failure,” published in the June 2024 issue of Pediatrics by Yagiela et al.

Adherence to follow-up appointments post-discharge from a pediatric intensive care unit (PICU) is crucial for managing the sequelae of critical illnesses. However, research on PICU follow-up adherence remains limited. This study aims to identify hospitalization characteristics, discharge health metrics, and follow-up attributes associated with full adherence to recommended follow-up care at a quaternary care center after PICU admission due to respiratory failure. Researchers conducted a retrospective cohort study involving patients aged ≤18 years admitted with respiratory failure to a quaternary care PICU between January 2013 and December 2014. Adherence to follow-up care within two years post-discharge (January 2013 to March 2017) was assessed and compared based on demographics, baseline health metrics, hospitalization characteristics, discharge health metrics, and follow-up attributes through bivariate and multivariate analyses. 

Patients were categorized into groups of non-adherent (attending less than 100% of recommended appointments) and fully adherent (attending 100% of recommended appointments). Out of 155 patients alive at discharge, 140 (90.3%) were advised to follow up at the quaternary care center. Among these 140 patients, 32.1% were non-adherent, while 67.9% were fully adherent. Multivariable logistic regression analysis revealed that each additional recommended unique follow-up appointment was associated with lower odds of full adherence (OR 0.74, 95% CI 0.60–0.91, p = 0.005), whereas a 10% increase in the proportion of appointments scheduled before discharge was linked to higher odds of full adherence (OR 1.02, 95% CI 1.01–1.03, p = 0.004). 

These findings indicate that only two-thirds of children adhered fully to recommended follow-up care after PICU admission for acute respiratory failure. The study suggests that focusing follow-up recommendations on essential healthcare providers and scheduling as many appointments as possible before discharge may enhance adherence. Further understanding of factors contributing to non-adherence is necessary to inform broader, system-level interventions to improve PICU follow-up adherence. This study highlights the importance of targeted strategies to ensure comprehensive post-discharge care for pediatric patients recovering from critical illnesses.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04888-8