Health-Related Quality of Life Outcomes of a Telehealth Care Coordination Intervention for Children With Medical Complexity: A Randomized Controlled Trial.

The final analysis included only 89 families, and the study had too few families to reliably detect differences in quality of life scores. Many families were excluded for missing baseline or year 2 data, and the reasons for missing data are unknown in many cases. Families with missing data may have differed from those included, which could bias the results. Among families still in the study through year 2, 35% of intervention groups and 51% of the control group were excluded because of missing data. Attrition was 6% in intervention groups and 15% in the control group. All participants already received team-based care in a structured special needs program, so the result may not apply to families without ready access to such care. The control group was small and likely not representative, and parents in it were more educated and more often married or partnered than parents in the intervention groups. Video was used in only 7% of encounters in the telephone plus video group, so the study did not test frequent video use. The quality of life measures used here may not capture what families consider important for children with severe neurologic impairment, because items such as walking, sports, and schoolwork may not change with care coordination.

The authors reported no financial interests or potential conflicts of interest.

Do not conclude that telehealth care coordination does not help children with medical complexity. This analysis had too few families to reliably detect quality of life differences, many families were excluded for missing data, and all families already received a structured care coordination program, so the result may not apply to families without that level of support.