The authors present a retrospective medical notes review of babies attending outpatient appointments for retinopathy of prematurity (ROP) examination, over a 12-month period. The aim of the study was to assess compliance with these appointments at a single centre. Data was collected from medical and clinic appointment records (including appointments scheduled and attended), other relevant clinical contacts, contact with Child Protective Services (CPS), demographics, birth weight, gestational age, ROP grade at discharge, laser treatment delivered, maternal ethnicity, social history and proximity to the hospital. A total of 66 babies were included in the study analysis. The majority (95%) were assessed for ROP prior to discharge with 64% identified to have incomplete retinal vascularisation and 33% received laser treatment. The cohort had 197 appointments scheduled, a mean of three per baby. There was a mean of 2.5 appointments attended per baby. Three-quarters attended all ROP appointments and were fully compliant. For children with CPS involvement there was a mean of five missed appointments. The factors identified as statistically significantly contributing to compliance with lower compliance reported in African American mothers, households with below median income, younger gestational age, lower birth weight and not receiving laser treatment prior to discharge in a univariate analysis. In a multivariate analysis, only low birth weight remained significant as a factor influencing non-compliance with outpatient ROP appointments. The compliance figures are better than comparable studies published before the release of the American Academy of Pediatrics’ recommendations to schedule appointments prior to discharge. A strength of this study was the multiple data sources employed. The authors acknowledge limitations including single-centre recruitment and only a single year of data which was during / immediately post the global Covid-19 pandemic. This study highlights the need to communicate with carers to improve follow-up rates.
What factors influence attendance at retinopathy of prematurity screening follow-up?
Reviewed by Lauren Hepworth
Determinants of compliance with outpatient examinations for infants at risk for retinopathy of prematurity.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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