Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study
BackgroundMonitoring ocular morbidity among pediatric patients requires regular follow-up visits. We found that the follow-up rate was poor among children in our setting. Therefore, we intended to assess the effectiveness of 2 interventions—(1) counseling and (2) SMS text mes...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-02-01
|
| Series: | JMIR Pediatrics and Parenting |
| Online Access: | https://pediatrics.jmir.org/2023/1/e43814 |
| _version_ | 1797734298944536576 |
|---|---|
| author | Manisha Shrestha Gopal Bhandari Sureshkumar Kamalakannan Gudlavalleti Venkata Satyanarayana Murthy Suresh Kumar Rathi Anirudh Gaurang Gudlavalleti Varun Agiwal Hira Pant Binod Pandey Ramesh Ghimire Daman Ale Sajani Kayastha Rakshya Karki Daya Shankar Chaudhary Raghunandan Byanju |
| author_facet | Manisha Shrestha Gopal Bhandari Sureshkumar Kamalakannan Gudlavalleti Venkata Satyanarayana Murthy Suresh Kumar Rathi Anirudh Gaurang Gudlavalleti Varun Agiwal Hira Pant Binod Pandey Ramesh Ghimire Daman Ale Sajani Kayastha Rakshya Karki Daya Shankar Chaudhary Raghunandan Byanju |
| author_sort | Manisha Shrestha |
| collection | DOAJ |
| description |
BackgroundMonitoring ocular morbidity among pediatric patients requires regular follow-up visits. We found that the follow-up rate was poor among children in our setting. Therefore, we intended to assess the effectiveness of 2 interventions—(1) counseling and (2) SMS text messaging and phone calls—to improve the follow-up rates.
ObjectiveThis study aimed to evaluate the effectiveness of 2 interventions, counseling and SMS and phone calls group, as well as a routine standard care for improving the follow-up rate of pediatric patients.
MethodsA Nonrandomized, quasiexperimental design was used. Children (aged 0-16 years) with ocular conditions requiring at least 3 follow-up visits during the study period were included. A total of 264 participants were equally allocated to the 3 intervention groups of (1) counseling, (2) SMS and phone calls, and (3) routine standard care group. A 20-minute counseling session by a trained counselor with the provision of disease-specific leaflets were given to those in the counseling group. For the second intervention group, parents of children received an SMS text 3 days before and a phone call 1 day before their scheduled follow-up visits. Participants allocated for the routine standard care group were provided with the existing services with no additional counseling and reminders. Participants attending 3 follow-ups within 2 days of the scheduled visit date were considered compliant. The difference in and among the proportion of participants completing all 3 follow-up visits in each group was assessed.
ResultsThe demographic characteristics of the participants were similar across the study groups. Only 3% (8/264) of participants completed all 3 follow-up visits, but overall compliance with the follow-up, as defined by the investigators, was found to be only 0.76% (2/264). There was no statistically significant difference in the proportion of follow-up between the intervention groups. However, the proportion of participants attending the first and second follow-ups, as well as the overall total number of follow-ups, was more in the SMS and phone-call group followed by the counseling group.
ConclusionsWe did not find any evidence on the effectiveness of our interventions to improve the follow-up rate. The primary reason could be that this study was conducted during the COVID-19 pandemic. It could also be possible that the intensity of the interventions may have influenced the outcomes. A rigorously designed study during the absence of any lockdown restrictions is warranted to evaluate intervention effectiveness. The study also provides useful insights and highlights the importance of designing and systematically developing interventions for improving the follow-up rate and ensuring a continuum of care to children with visual disabilities in Nepal and similar contexts.
Trial RegistrationClinicalTrials.gov NCT04837534; https://clinicaltrials.gov/ct2/show/NCT04837534
International Registered Report Identifier (IRRID)RR2-10.2196/31578 |
| first_indexed | 2024-03-12T12:41:17Z |
| format | Article |
| id | doaj.art-4ca1a82a119d49d8b63c9d121ca803be |
| institution | Directory Open Access Journal |
| issn | 2561-6722 |
| language | English |
| last_indexed | 2024-03-12T12:41:17Z |
| publishDate | 2023-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Pediatrics and Parenting |
| spelling | doaj.art-4ca1a82a119d49d8b63c9d121ca803be2023-08-28T23:46:44ZengJMIR PublicationsJMIR Pediatrics and Parenting2561-67222023-02-016e4381410.2196/43814Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized StudyManisha Shresthahttps://orcid.org/0000-0002-2498-5401Gopal Bhandarihttps://orcid.org/0000-0001-9452-8874Sureshkumar Kamalakannanhttps://orcid.org/0000-0001-6970-4952Gudlavalleti Venkata Satyanarayana Murthyhttps://orcid.org/0000-0002-5695-866XSuresh Kumar Rathihttps://orcid.org/0000-0002-8480-1627Anirudh Gaurang Gudlavalletihttps://orcid.org/0000-0001-7339-5320Varun Agiwalhttps://orcid.org/0000-0003-1955-8832Hira Panthttps://orcid.org/0000-0002-7759-7218Binod Pandeyhttps://orcid.org/0000-0002-3593-0588Ramesh Ghimirehttps://orcid.org/0000-0002-1203-8255Daman Alehttps://orcid.org/0000-0002-1107-0018Sajani Kayasthahttps://orcid.org/0000-0003-2804-1026Rakshya Karkihttps://orcid.org/0000-0002-4634-2220Daya Shankar Chaudharyhttps://orcid.org/0000-0002-4205-8580Raghunandan Byanjuhttps://orcid.org/0000-0003-3486-1768 BackgroundMonitoring ocular morbidity among pediatric patients requires regular follow-up visits. We found that the follow-up rate was poor among children in our setting. Therefore, we intended to assess the effectiveness of 2 interventions—(1) counseling and (2) SMS text messaging and phone calls—to improve the follow-up rates. ObjectiveThis study aimed to evaluate the effectiveness of 2 interventions, counseling and SMS and phone calls group, as well as a routine standard care for improving the follow-up rate of pediatric patients. MethodsA Nonrandomized, quasiexperimental design was used. Children (aged 0-16 years) with ocular conditions requiring at least 3 follow-up visits during the study period were included. A total of 264 participants were equally allocated to the 3 intervention groups of (1) counseling, (2) SMS and phone calls, and (3) routine standard care group. A 20-minute counseling session by a trained counselor with the provision of disease-specific leaflets were given to those in the counseling group. For the second intervention group, parents of children received an SMS text 3 days before and a phone call 1 day before their scheduled follow-up visits. Participants allocated for the routine standard care group were provided with the existing services with no additional counseling and reminders. Participants attending 3 follow-ups within 2 days of the scheduled visit date were considered compliant. The difference in and among the proportion of participants completing all 3 follow-up visits in each group was assessed. ResultsThe demographic characteristics of the participants were similar across the study groups. Only 3% (8/264) of participants completed all 3 follow-up visits, but overall compliance with the follow-up, as defined by the investigators, was found to be only 0.76% (2/264). There was no statistically significant difference in the proportion of follow-up between the intervention groups. However, the proportion of participants attending the first and second follow-ups, as well as the overall total number of follow-ups, was more in the SMS and phone-call group followed by the counseling group. ConclusionsWe did not find any evidence on the effectiveness of our interventions to improve the follow-up rate. The primary reason could be that this study was conducted during the COVID-19 pandemic. It could also be possible that the intensity of the interventions may have influenced the outcomes. A rigorously designed study during the absence of any lockdown restrictions is warranted to evaluate intervention effectiveness. The study also provides useful insights and highlights the importance of designing and systematically developing interventions for improving the follow-up rate and ensuring a continuum of care to children with visual disabilities in Nepal and similar contexts. Trial RegistrationClinicalTrials.gov NCT04837534; https://clinicaltrials.gov/ct2/show/NCT04837534 International Registered Report Identifier (IRRID)RR2-10.2196/31578https://pediatrics.jmir.org/2023/1/e43814 |
| spellingShingle | Manisha Shrestha Gopal Bhandari Sureshkumar Kamalakannan Gudlavalleti Venkata Satyanarayana Murthy Suresh Kumar Rathi Anirudh Gaurang Gudlavalleti Varun Agiwal Hira Pant Binod Pandey Ramesh Ghimire Daman Ale Sajani Kayastha Rakshya Karki Daya Shankar Chaudhary Raghunandan Byanju Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study JMIR Pediatrics and Parenting |
| title | Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study |
| title_full | Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study |
| title_fullStr | Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study |
| title_full_unstemmed | Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study |
| title_short | Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study |
| title_sort | evaluating the effectiveness of interventions to improve the follow up rate for children with visual disabilities in an eye hospital in nepal nonrandomized study |
| url | https://pediatrics.jmir.org/2023/1/e43814 |
| work_keys_str_mv | AT manishashrestha evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT gopalbhandari evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT sureshkumarkamalakannan evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT gudlavalletivenkatasatyanarayanamurthy evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT sureshkumarrathi evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT anirudhgauranggudlavalleti evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT varunagiwal evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT hirapant evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT binodpandey evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT rameshghimire evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT damanale evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT sajanikayastha evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT rakshyakarki evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT dayashankarchaudhary evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy AT raghunandanbyanju evaluatingtheeffectivenessofinterventionstoimprovethefollowuprateforchildrenwithvisualdisabilitiesinaneyehospitalinnepalnonrandomizedstudy |