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Behavioural interventions to increase adherence to palivizumab prophylaxis in children with CHD

Published online by Cambridge University Press:  26 April 2024

Elif Erolu Open the ORCID record for Elif Erolu [Opens in a new window] ,
Özgür Kıbrıs ,
Yasemin Tosun ,
Ayse Yildirim ,
Ozge Pamukcu Open the ORCID record for Ozge Pamukcu [Opens in a new window] ,
Evic Zeynep Basar Open the ORCID record for Evic Zeynep Basar [Opens in a new window] ,
Kadir Babaoglu Open the ORCID record for Kadir Babaoglu [Opens in a new window] ,
Serdar Epcacan Open the ORCID record for Serdar Epcacan [Opens in a new window] ,
Yasemin Donmez Open the ORCID record for Yasemin Donmez [Opens in a new window]  and
Dilek Giray Open the ORCID record for Dilek Giray [Opens in a new window]
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Elif Erolu*
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences Medical School Kartal Kosuyolu High Speciality Educational and Research Hospital, Istanbul, Turkey
Özgür Kıbrıs
Affiliation:
Faculty of Arts and Social Sciences, Sabancı University, Istanbul, Turkey
Yasemin Tosun
Affiliation:
Faculty of Arts and Social Sciences, Sabancı University, Istanbul, Turkey
Ayse Yildirim
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences Medical School Kartal Kosuyolu High Speciality Educational and Research Hospital, Istanbul, Turkey
Ozge Pamukcu
Affiliation:
Department of Pediatric Cardiology, Maras Necip Fazil City Hospital, Merkez, Turkey
Evic Zeynep Basar
Affiliation:
Department of Pediatric Cardiology, Kocaeli University, Kocaeli, Turkey
Kadir Babaoglu
Affiliation:
Department of Pediatric Cardiology, Kocaeli University, Kocaeli, Turkey
Serdar Epcacan
Affiliation:
Department of Pediatric Cardiology, Van Research and Education Hospital, Van, Turkey
Yasemin Donmez
Affiliation:
Department of Pediatric Cardiology, Van Research and Education Hospital, Van, Turkey
Dilek Giray
Affiliation:
Department of Pediatric Cardiology, Van Research and Education Hospital, Van, Turkey
Pınar Dervisoglu
Affiliation:
Department of Pediatric Cardiology, Sakarya University, sakarya, Turkey
Onur Tascı
Affiliation:
Department of Pediatric Cardiology, Sivas Numune Hospital, Sivas, Turkey
*
Corresponding author: E. Erolu; Email: eliferolu@yahoo.com
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Abstract

Objectives:

Adherence to palivizumab prophylaxis programmes is crucial to protect infants with CHD against respiratory syncytial virus infections. We analysed the effectiveness of two nudge interventions in increasing adherence.

Methods:

Our study included 229 infants, and their caregivers, from five centers in Turkey in the 2020–2021 respiratory syncytial virus season. We randomly allocated caregivers to a control and two intervention groups. Caregivers in all groups were informed about the prophylaxis programme and provided a schedule. Additionally, caregivers in Intervention 1 were called two days before appointments (default bias) and were asked to plan the appointment day (implementation intention), whereas caregivers in Intervention 2 received biweekly text messages informing them about the programme’s benefits (availability bias) and current adherence rate (social norm).

Results:

Caregivers in Intervention 1 had a significantly higher adherence rate than Control (97.3% versus 90.9%) (p = 0.014). Both interventions had a significant effect on participants in their first prophylaxis season (p = 0.031, p = 0.037). Families where the father was employed had a 14.2% higher adherence rate (p = 0.001). Every additional child was associated with a 2.2% decrease in adherence rate (p = 0.02). In control, ICU admission history was associated with an 18.8% lower adherence rate (p = 0.0001), but this association disappeared in intervention groups.

Conclusion:

This is the first prospective interventional study which, in the context of palivizumab prophylaxis, analyses the effectiveness of nudge interventions based on established cognitive biases by comparing randomly generated intervention and control groups. We found that default bias and implementation intention have significant effects on adherence.

Clinical trial, in the name and number “Adherence of palivizumab prophylaxis, NCT05778240” registered retrospectively. https://clinicaltrials.gov/ct2/show/NCT05778240.

Keywords

respiratory syncytial viruspalivizumab prophylaxiscognitive biasbehavioural interventionCHD

Information

Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 9 , September 2024 , pp. 1877 - 1884
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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