Assessment of compliance with home cardiorespiratory monitoring in infants at risk of sudden infant death syndrome. Collaborative Home Infant Monitoring Evaluation (CHIME).
OBJECTIVE
Documented monitoring was used to evaluate prospectively (1) the level of compliance among infants in whom cardiorespiratory monitoring was clinically indicated and (2) factors that might influence compliance: diagnosis, socioeconomic status, maternal age and education, and alarms.


METHODS
Sixty-seven infants (51% female, 49% term) were sequentially enrolled, and monitoring was prescribed for the following indications: siblings of sudden infant death syndrome victims (16%), apnea of prematurity (45%), and apparent life-threatening events or apnea of infancy (39%). Demographic data, alarm and event data, and a summary report of monitor use from the first monitor download were obtained.


RESULTS
Maternal age, education, and insurance status did not differ significantly by indication for monitoring. The median number of monitor alarms per 10 hours of use was 0.7 for apnea or bradycardia and 0.6 for loose lead alarms. Monitors were available for use in the home from 2 to 106 days (median, 11 days). Median hours of monitor use per full day in the home was 15.5 hours. Of 67 infants, 58 used the monitor for at least part of every day in the home. The number of hours of monitor use per day did not differ significantly by diagnostic category, chronologic age, alarms, maternal age, education, or insurance type. This study population of infants at increased risk of sudden infant death syndrome had excellent compliance; 75% of the infants were monitored more than 10.5 hours per day, and 25% were monitored more than 21 hours per day.


CONCLUSIONS
Documented monitoring provides an objective measure of compliance. These data provide a potential goal for level of compliance with home cardiorespiratory monitoring.
Silvestri
J M
JM
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
Hufford
D R
DR
Durham
J
J
Pearsall
S M
SM
Oess
M A
MA
Weese-Mayer
D E
DE
Hunt
C E
CE
Levenson
S M
SM
Corwin
M J
MJ
D000704:Analysis of Variance; D002320:Cardiovascular Physiological Phenomena; D016009:Chi-Square Distribution; D004522:Educational Status; D005260:Female; D006701:Home Nursing / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008423:Maternal Age; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013398:Sudden Infant Death / Q000175:diagnosis / Q000517:prevention & control*