A new paradigm for incorporating the joint statement screening guidelines for retinopathy of prematurity into clinical practice: outcomes from a quaternary referral program.

BACKGROUND AND OBJECTIVE: This study examines patient experience at a quaternary referral pediatric clinic with a retinopathy of prematurity (ROP) screening program that monitors infants at least on a weekly basis for any stage of ROP. PATIENTS AND METHODS: Admission records of 399 prematurely born patients treated at the Byers Eye Institute outpatient ROP clinic were retrospectively reviewed. Patients were categorized according to ROP status and whether they completed, canceled, or failed to show up for scheduled examinations. Demographic information was collected from medical records. RESULTS: Of 1,823 scheduled ROP-related visits, 327 (17.9%) resulted in cancellations and 90 (4.9%) in no-shows, with 238 missed visits due to caregiver-related and 149 due to caregiver-unrelated reasons. Of 399 total patients, 142 (35.6%) canceled or failed to show up for at least one appointment because of caregiver-related reasons. CONCLUSION: More than one-third of patients with ROP canceled or missed appointments. The true risk of delay is difficult to assess because all patients requiring treatment received it prior to discharge from the hospital. To achieve maximal compliance with joint statement guidelines on ROP screening, patients should be scheduled for examination earlier than recommended.