Assessing the Impact of a Telemedicine Program on Caregivers of Children With Complex Chronic Conditions: Pre-Post Intervention Study

评估远程医疗项目对患有复杂慢性疾病儿童的照护者的影响:干预前后研究

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Abstract

BACKGROUND: The COVID-19 pandemic was a paradigm shift in global health care. This situation highlighted the role of telemedicine in adapting to the care requirements of pediatric patients and their families by facilitating remote consultations and ensuring continuity of care. OBJECTIVE: We aimed to establish the usefulness of a telemedicine program for caregivers of children with complex chronic conditions. METHODS: We performed a quasi-experimental pre-post intervention study of a telemedicine program, regarding health care system use and caregiver quality of life while comparing two periods: before and during the COVID-19 pandemic. This study included caregivers of children with complex chronic conditions followed-up in a specialized unit. RESULTS: A total of 34 families were included. The mean number of visits per year was higher in the preintervention period for both primary care consultations (P=.03) and hospital-specialized medical consultations (P=.03). The number of emergency room visits per year was lower in the pandemic period compared to the prepandemic period (P=.01). In both groups, an improvement in caregiver quality of life was detected at 12 months (P=.03). However, the Rosenberg self-esteem scale score for the primary caregiver was significantly lower at 3 months compared to the baseline (P=.03). CONCLUSIONS: Our study demonstrates that the use of a telemedicine program resulted in decreased scheduled face-to-face care visits and a reduction in the number of emergency department visits. Regarding the caregiver quality of life, outcomes were poorer among families whose children were affected by neurological conditions or were diagnosed at an older age.

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