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Background:Remote patient monitoring (RPM) for pediatric chronic conditions promotes proactive healthcare communication and improves the rate of tube feeding (TF) weaning success. Current TF weaning programs have standards of care for data gathering but are reactive, waiting for parents to report through the patient portal or relying solely upon in-person visits. To improve TF weaning, the CMKC’s Interdisciplinary Feeding and Remote Home Monitoring teams have partnered to use the CHAMP® App to support TF weaning. This proposal’s overall objective is to evaluate the impact of the expansion of the CHAMP® App software on TF weaning success at CMKC.

Methods:We conducted a single-site observational study evaluating the success rate (%) and frequency of children (n) that were able to successfully wean from TF (100% of calories by mouth) while maintaining age-appropriate growth using the CHAMP App, compared with those using only a standard outpatient interdisciplinary feeding tube using a tube weaning algorithm (pre-implementation 6-month period) for children aged 1 month to 4 years scheduled in the feeding clinic.

Results: The pre-implementation period (Jan-July 2023) found a tube weaning attempt in 13.8% (17/141) of patients, with 41.2% of those children (7/17) successfully weaning to all calories by mouth. Patients who attempted to wean pre-state were very medically complicated, around 2 years of age, with each having at least one prior hospitalization and they were followed by an average of 6 medical specialties. Weight loss over 10% of baseline weight was the most frequently charted reason for "failed" trial. In a preliminary analysis of the post-implementation group with CHAMP App, 11/2023-Current Feb/2024, 10% (15/150) of children were enrolled, and 100% of those who have completed the study to date (n=9) reached all calories by mouth. Five patients are actively weaning, one is waiting to wean per parent preference, and we continue with study enrollment.

Conclusions: CHAMP® has the potential to revolutionize outpatient TF weaning at CMKC and nationally. We have successfully weaned more children (n=9) in the first 3 months of CHAMP App implementation than the prior 6 months using standard of care TF weaning (n=7). CHAMP® has dramatically improved our team’s capacity for TF weaning and our ability to proactively monitor, communicate, and intervene throughout the TF weaning process. We will continue to recruit for this study and anticipate that CHAMP® will not only improve our success at TF weaning but also dramatically improve patient and family experience.

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Implementation of a Remote Software Platform for Pediatric Patients ready to Wean from Tube Feeding: CHAMP for the Feeder