Adherence to Symptom-Based Care Guidelines for Down Syndrome. (February 2017)

• Record Type: Journal Article
• Authors: Santoro, Stephanie L.; Yin, Han; Hopkin, Robert J.
• Is Part Of: Clinical pediatrics. Volume 56:Number 2(2017)
• Page Start: 150
• Page End: 156
• Publication Date: 2017-02
• Subjects: Down syndrome -- health care guidelines -- sleep study -- obstructive sleep apnea -- adherence; Pediatrics -- Periodicals; 618.920005
• DOI: 10.1177/0009922816652416
• Languages: English
• ISSNs: 0009-9228

Abstract

To assess adherence to symptom-based studies recommended in the health supervision guidelines for Down syndrome from the American Academy of Pediatrics (AAP), 24 pediatric care sites participated in retrospective chart review. Symptom-based screening and 4 associated recommendations, including cervical spine radiograph, video swallow study, celiac study with tissue transglutaminase and sleep study were analyzed by reviewing well-child visit notes of 264 children with Down syndrome. Given trends toward symptom-based screens, Pearson's chi-square test and Fisher's exact test were used to determine the association between symptom presence and receiving corresponding symptom-based screens. Adherence rates were widely variable ranging from 0% to 79% completion. Symptom-based studies were performed in 22% to 36% of patients. Symptom screens were documented positive in many patients, but the presence of symptoms did not correlate with completion of symptom-based screens. Symptom-based screening is low; associated studies were performed in patients without documented symptoms contrary to AAP recommendation.