Compliance with recommended follow-ups for retinopathy of prematurity in a tertiary care center in Iran (2020-2023)
Kia Bayat, MD, H-MBA1 , Hossein Hatami, MD, MPH -Corresponding author2 , Sare Safi, PhD3 , Hamid Safi, MD4 , Morteza Entezati, MD4 , Homayoun Nikkhah, MD4 , Parisa Pooyan, MD, H-MBA5 , Zahra Khorrami, Ph.D3 , Zahra Taghizade, MD5 , Alireza Ramezani, MD -Corresponding author6 *
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Public Health, School of Public Health & Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran - Department of Ophthalmology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract: To determine the rate and reasons for non-compliance with follow-ups in retinopathy of prematurity (ROP).
Methods: In this retrospective study, we extracted the medical records from 718 infants who were visited between 2020 and 2023 at a tertiary hospital ROP clinic. Gender, gestational age, birth weight, ROP zone and stage, presence of plus or pre plus disease, insurance coverage, parent’s age and level of education were reported. A phone interview was performed to assess the reasons for non-compliance and to complete the demographic information.
Results: The records of 400 male (55.7%) and 318 female infants (44.3%) were assessed. The mean gestational age and birth weight were 33.2 ± 2.54 weeks and 1951 ± 573 grams, respectively. The rate of ROP more than stage 0 was 25.8% at first visit. In addition, 71 infants (9.9%) presented with preplus, and 18 (2.5%) with plus disease. Corresponding values were 51 (7.1%), 22 (3.1%), and 2 (0.3%) infants in the final visit. Response rate of the phone interview was 89.1%. Insurance coverage was 89.4% and mean father’s and mother’s ages were 36.18 ± 5.984 and 32.36 ± 6.362 years, respectively. Ten fathers (1.6%) and 16 mothers (2.5%) were illiterate and 237 fathers (37%) and 267 of mothers (41.7%) had degrees above diploma. Three hundred and twelve patients (43.5%) completed the course of follow-up according to their physician’s recommendations and 144 of them (20.1%) pursued the remaining examinations in other centers. The reasons for noncompliance were access/affordability in 32 patients (12.6%), parents' concerns and problems in 137 patients (53.9%), infant’s comorbidities in 9 patients (3.5%), and unknown reasons in 76 children (29.9%). We also investigated attending with delay in follow-up sessions based on the recommended return-to-clinic (RTC) time which was given to the patients by their physician. Two hundred and fifty eight patients (35.9%) have attended with delay at least in one follow up.
Conclusion: Almost one third of patients did not complete the course of follow-ups. The principal reason for non-compliance was parents' concerns and problems.
