Abstract 14735: REACH: Does Telehealth Influence Maternal and Neonatal Outcomes in Post-Cardiac Surgery for Congenital Heart Disease

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A14735-A14735
• Main Authors: Medoff-Cooper, Barbara, Fleck, Desiree A, Ravishankar, Chitra, Costello, John M, Huang, Liming, Hanlon, Alexandra L, Marino, Bradley S, Curley, Martha A
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionParents of infants who have undergone cardiac surgery experience significant stress when transitioning home. To date, home monitoring programs have not been prospectively evaluated and have not included all infants known to be at risk for both morbidity and mortality.HypothesisWe hypothesized that REACH (home telehealth monitoring program would decrease parental stress, increase parental quality of life and increase infant stability as evidenced by weight gain.MethodsWe conducted a three center randomized clinical trial to test the effect of a 4-month Telehealth Home Care intervention (REACH) on post-discharge outcomes in parents and their infants who were recovering from cardiac surgery. Parental outcome measures included the Parental Stress Index (PSI long form), Posttraumatic Diagnostic Scale (PTDS), and quality of life (ULQIE). Infant outcomes included weight-for-age z-score at study end and hospital readmissions.ResultsA total of 178 parent-infant dyads were enrolled. In both groups, parental PSI scores at study end were above the 99 percentile. The percent of parent participants meeting diagnostic criteria for PTSD was high but not different between groups (44% REACH intervention, 39% control; p=0.68). Overall, at study end, the mean weight for age z-score did not differ between treatment groups (REACH intervention, -1.08 ± 1.23, Control, -1.35 ±1.08; p=0.19); nor did the number of infants with at least one hospital readmission during the study (REACH intervention 45%; Control, 40%; p=0.14)ConclusionsStress levels and PTSD rates remain high during the first four months after neonatal cardiac surgery, and suboptimal infant growth and hospital readmission rates remain problematic. The intensive telehealth home care intervention (REACH) was not associated with improvement in parent or infant outcomes.