Introduction
Bringing home a child with major congenital heart disease (CHD) is difficult and anxiety levels are often high. As a regional service, patients may be distant from specialist help if problems arise. This study aimed to assess the effect of home support by videoconferencing compared with telephone support on: parental anxiety, patient management, health service utilization and cost implications.

Methods
Prospective, randomized, control trial: video-conference support, telephone support and control group. Patients with major CHD were included if significant support was anticipated post-discharge. Home support provided for 10 weeks. Parental anxiety was assessed using standardised questionnaires.

Results
Over 4 year study period, 105 families included. Age range= 8– 490 days. Video-conference group- n=36, telephone group=32, control group= 37. Median reduction in anxiety score: video-conference group= 6, telephone group= 3 (p<0.05). Clinicians felt able to adequately address families’ concerns more often in video-conference group (91% vs 64%, p<0.05) and were more likely to advise seeking direct health service assessment in telephone group (4% vs 20%, p<0.05). Mean number of health service episodes per patient per week was significantly lower in video-conference group compared with both telephone and control groups (0.48 vs 0.81 vs 0.72, p=0.02). The sum of providing home support and health service episodes was significantly lower in the videoconference group compared with both telephone and control groups (p<0.01).

Discussion
Home support for children with major congenital heart disease via video-conferencing decreases parental anxiety compared with telephone support, affects patient management, decreases health service utilization and may be cost-saving.