Factors Associated With Home Visits in a 5-Year Study of Acute Respiratory Distress Syndrome Survivors.

ABSTRACT

BACKGROUND: Participant retention is vital for longitudinal studies. Home visits may increase retention, but little is known about the subset of patients they benefit. OBJECTIVE: To evaluate patient-related variables associated with home visits. METHODS: In a 5-year, longitudinal, multisite, prospective study of 195 survivors of acute respiratory distress syndrome, in-person assessments were conducted at a research clinic. Home visits were offered to participants who could not attend the clinic. Associations between having a home visit, prior follow-up visit status, and baseline and in-hospital patient variables were evaluated with multivariable, random-intercept logistic regression models. The association between home visits and patients' posthospital clinical status was evaluated with a subsequent regression model adjusted for these variables. RESULTS: Participants had a median age of 49 years and were 56% male and 58% White. The following had independent associations with home visits (adjusted odds ratio [95% CI]) age (per year 1.03 [1.00-1.05]) and immediately preceding visit incomplete (2.46 [1.44-4.19]) or at home (8.24 [4.57-14.86]). After adjustment for prior-visit status and baseline and hospitalization variables, these posthospital patient outcome variables were associated with a subsequent home visit instrumental activities of daily living (≥ 2 vs < 2 dependencies 2.32 [1.29-4.17]), EQ-5D utility score (per 0.1-point decrease 1.15 [1.02-1.30]), and 6-minute walk test (per 10-percentage-point decrease in percent-predicted distance 1.50 [1.26-1.79]). CONCLUSIONS: Home visits were important for retaining older and more physically impaired study participants, helping reduce selection bias caused by excluding them.