HOW CAN NEW TECHNOLOGIES HELP REDUCE ABSENTEEISM IN PEDIATRIC CONSULTATION?

• Published in: Revista Paulista de Pediatria Vol. 38; p. e2018313
• Main Authors: Bueno, Neliane da Silva, Rossoni, Andrea Maciel de Oliveira, Lizzi, Elisângela Aparecida da Silva, Tahan, Tony Tanous, Hirose, Tatiane Emi, Chong Neto, Herberto José
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade de Pediatria de São Paulo 01.01.2020
• Subjects: Absenteeism; Child; Original; Treatment refusal; Tuberculosis
• ISSN: 0103-0582; 1984-0462
• DOI: 10.1590/1984-0462/2020/38/2018313

To identify the most effective form of contact, as a possible intervention to reduce absenteeism in consultations of children with suspected or confirmed pulmonary tuberculosis. A randomized clinical trial was conducted with prospective data collection, between March 2017 and February 2018. Patients were randomized into three groups to be reminded about the appointment: telephone contact, SMS or WhatsApp, or no intervention. A convenience sample was obtained, with a significance level of 5%. 78 children were included, with a median age of four years old (zero to 14); 59.0% of them were in treatment for a latent infection and 6.4% had active tuberculosis. Among the 78 children, 74.4% lived in Curitiba (Sourhern Brazil); 62.8% lived with both parents; 38.5% of the parents had formal employment and 47.4% of the mothers were housewives; 50.8% of the fathers and 55.7% of the mothers had more than nine years of schooling. In 78.2% of the families, per capita income was up to 0.5 minimum wages; 27.3% were enrolled in social programs; 28.2% lived in homes provided by the government. There was a total of 238 interventions made: 85 (35.7%) by telephone contact, 78 (32.8%) by text message (WhatsApp was 97.2% of these) and 75 (31.5%) had no further contact. There was no statistical difference among the sociodemographic and cultural characteristics studied. The absenteeism rate was 24.0% and the abandonment rate was 16.7%. Giving a reminder to the patient's guardian prior to the consultation, regardless of the intervention (p=0.021) and specifically by WhatsApp message (p=0.032) was associated with no absenteeism, though it was not associated with abandonment of the treatment. Using new tools, such as WhatsApp, to remind guardians of appointments reduces absenteeism. Consequently, it may lead to a reduction in abandoning treatment and it may improvetreatment outcome of children with a tuberculosis infection or disease.