Effects of Immediate Telephone Follow-Up with Providers on Sweat Chloride Test Timing after Cystic Fibrosis Newborn Screening Identifies a Single Mutation

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• 作者：Alison La Pean ; MS ; CGC¹ ; Michael H. Farrell ; MD¹ ; Kerry L. Eskra ; MS¹ ; ² ; Philip M. Farrell ; MD ; PhD³
• 关键词：CF ; Cystic fibrosis ; CFTR ; CF transmembrane conductance regulator ; COR ; Clinician of record ; FTE ; Full-time equivalent ; IRT ; Immunoreactive trypsinogen ; NBS ; Newborn screening ; PCP ; Primary care provider
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：162
• 期：3
• 页码：522-529
• 全文大小：312 K

文摘

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Objective

To assess whether reporting ¡°possible cystic fibrosis (CF)¡± newborn screening (NBS) results via fax plus simultaneous telephone contact with primary care providers (PCPs) versus fax alone influenced 3 outcomes: undergoing a sweat chloride test, age at sweat chloride testing, and undergoing sweat testing before age 8 weeks.

Study design

This was a retrospective cohort comparison of infants born in Wisconsin whose PCP received a telephone intervention (n?=?301) versus recent historical controls whose PCP did not (n?=?355). Intervention data were collected during a longitudinal research and quality improvement effort; deidentified comparison data were constructed from auxiliary NBS tracking information. Parametric and nonparametric statistical analyses were performed for group differences.

Results

Most infants (92 % ) with ¡°possible CF¡± NBS results whose PCP lacked telephone intervention ultimately underwent sweat testing, underlining efficacy for fax-only reporting. Telephone intervention was significantly associated with improvements in the infants undergoing sweat testing at age ¡Ü6 weeks and <8 weeks and a slight, statistically nonsignificant 3.5-day reduction in the infants' age at sweat testing. The effect of telephone intervention was greater for PCPs whose patients underwent sweat testing at community-affiliated medical centers versus those whose patients did so at academic medical centers (m>Pm>?=?.008).

Conclusion

Reporting ¡°possible CF¡± NBS results via fax plus simultaneous telephone follow-up with PCPs increases the rate of sweat chloride testing before 8 weeks of age, when affected infants are more likely to receive full benefits of early diagnosis and treatment.