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Effect of Care Coordination Using an Allied Health Liaison Officer for Chronic Noncomplex Medical Conditions in
Thuy Thanh Frakking1,2,3, Hsien-Jin Teoh4, Doug Shelton5
1Research Development Unit, Caboolture Hospital, Queensland Health, Caboolture, Queensland, Australia.
Insights
Care coordination improved quality of life for children with chronic non-complex medical conditions (non-CMCs) and their families. This Allied Health Liaison Officer intervention led to significant QOL gains at 12 months.
Area of Science:
- Pediatric Health Services Research
- Quality of Life Studies
- Chronic Disease Management
Background:
- Limited evidence exists on care coordination's impact on quality of life (QOL) for children with chronic non-complex medical conditions (non-CMCs).
- Care coordination aims to improve health outcomes and patient experience by integrating services.
Purpose of the Study:
- To evaluate if care coordination by an Allied Health Liaison Officer enhances QOL for children with non-CMCs and their families.
- To address the evidence gap in pediatric chronic care management.
Main Methods:
- A multicenter, randomized clinical trial involving 81 children with non-CMCs across 3 Australian hospitals.
- Children were randomized to receive care coordination or standard care for up to 12 months.
- Outcomes measured using the Pediatric Quality of Life Inventory (PedsQL) and PedsQL Family Impact Module.
Main Results:
- Care coordination significantly improved overall PedsQL scores compared to standard care (P=.04).
- The intervention also led to greater improvements in the PedsQL Family Impact Module scores (P=.03) and family functioning QOL (P=.004).
- Improvements were observed at the 12-month follow-up.
Conclusions:
- Care coordination by an Allied Health Liaison Officer effectively enhances the quality of life for children with non-CMCs and their families.
- Further research should identify specific non-CMCs that benefit most and explore long-term clinical outcomes.
Importance:
There is a paucity of high-quality evidence on the effect of care coordination on health-related quality of life among children with chronic noncomplex medical conditions (non-CMCs).
Objective:
To examine whether care coordination delivered by an Allied Health Liaison Officer results in improved quality-of-life (QOL) outcomes for children with chronic non-CMCs and their families.
Design, Setting And Participants:
This multicenter, open label, randomized clinical trial was conducted in pediatric outpatient clinics at 3 Australian hospitals with tertiary- and secondary-level pediatric care facilities. A total of 81 children with chronic non-CMCs and their families participated in the trial for a period of up to 12 months between October 2017 to October 2020. Primary care reviews were offered at 1 week, 3 months, and 6 months after diagnosis.
Interventions:
Eligible children were randomized 1:1 to receive care coordination or standard care. Families of children receiving care coordination were provided access to an Allied Health Liaison Officer, who was responsible for facilitation of health care access across hospital, education, primary care, and community sectors.
Main Outcomes And Measures:
The primary outcomes were scores on the Pediatric Quality of Life Inventory (PedsQL), version 4.0, and the PedsQL Family Impact Module, version 2.0, measured at 6 and 12 months. An intent-to-treat approach was used to analyze the data.
Results:
Of 81 children (mean [SD] age, 8.2 [3.5] years; 55 [67.9%] male), 42 (51.9%) were randomized to care coordination and 39 (48.1%) to standard care. Compared with standard care, care coordination resulted in greater improvements in overall PedsQL scores (difference in score changes between groups, 7.10; 95% CI, 0.44-13.76; P = .04), overall PedsQL Family Impact Module scores (difference in score changes between groups, 8.62; 95% CI, 1.07-16.16; P = .03), and family functioning QOL (difference in score changes between groups, 15.83; 95% CI, 5.05-26.62; P = .004) at 12 months after diagnosis.
Conclusions And Relevance:
In this randomized clinical trial, care coordination improved the quality of life of children with chronic non-CMCs and their families. Further studies should explore specific non-CMCs that may benefit most from care coordination and whether an orientation among health services to provide such a coordination model could lead to longer-term improved clinical outcomes.
Trial Registration:
http://anzctr.org.au Identifier: ACTRN12617001188325.
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