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

## TL;DR

This study shows that a telemedicine program reduced in-person visits and emergency room use for children with chronic conditions, while also affecting caregiver quality of life.

## Contribution

The study provides new evidence on the impact of telemedicine on healthcare use and caregiver well-being during the pandemic.

## Key findings

- Telemedicine reduced scheduled face-to-face visits and emergency department use during the pandemic.
- Caregiver quality of life improved at 12 months but worsened at 3 months for some.
- Families with neurological conditions or older diagnoses had poorer outcomes in caregiver quality of life.

## Abstract

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.

We aimed to establish the usefulness of a telemedicine program for caregivers of children with complex chronic conditions.

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.

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).

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.