Case Management for Enhancing Wellbeing, Resilience, and Quality of Life in Caregivers of Children and Adolescents With Chronic Illnesses and Disabilities: A Systematic Review and Meta-Analysis.

The included trials had a high risk of bias, especially for outcome measurement, where 100% of studies were judged high risk. Most outcomes relied on self-reported caregiver measures, which can bias results. Only eight, six, and nine studies contributed to the three main outcomes, and only three studies reported follow-up data between 3 and 24 months. The trials came mostly from high-income countries, with 11 of 17 from the United States, so results may not transfer to other health systems. Case management programs varied widely and often combined care coordination, education, mentoring, and psychosocial support, so the review cannot identify which component helped. Five studies reported children's positive mental health outcomes, and those effects were small and inconsistent. The satisfaction funnel plot showed asymmetry, although the authors judged publication bias unlikely to have a major impact.

Three authors had previously been involved in evaluating a case management intervention for parents of chronically ill children. That intervention's results were unpublished and not included. The authors report no other conflicts.

Do not treat these effects as large or as proof that one component works. The programs mixed care coordination, education, mentoring, and psychosocial support, and the review cannot separate their effects.