Hospital-to-home transitions for children with medical complexity: part 2—a core outcome set

Appropriate outcome measures as part of high-quality intervention trials are critical to advancing hospital-to-home transitions for Children with Medical Complexity (CMC). Our aim was to conduct a Delphi study and focus groups to identify a Core Outcome Set (COS) that healthcare professionals and parents consider essential outcomes for future intervention research. The development process consisted of two phases: (1) a three-round Delphi study in which different professionals rated outcomes, previously described in a systematic review, for inclusion in the COS and (2) focus groups with parents of CMC to validate the results of the Delphi study. Forty-five professionals participated in the Delphi study. The response rates were 55%, 57%, and 58% in the three rounds, respectively. In addition to the 24 outcomes from the literature, the participants suggested 12 additional outcomes. The Delphi rounds resulted in the following core outcomes: (1) disease management, (2) child’s quality of life, and (3) impact on the life of families. Two focus groups with seven parents highlighted another core outcome: (4) self-efficacy of parents.

Conclusion: An evidence-informed COS has been developed based on consensus among healthcare professionals and parents. These core outcomes could facilitate standard reporting in future CMC hospital to home transition research. This study facilitated the next step of COS development: selecting the appropriate measurement instruments for every outcome.

Aim

This study aimed to reach a consensus on a set of core outcomes informed by healthcare
professionals and parents

Contributors

Heleen N. Haspels, Annemieke A. de Lange, Mattijs W. Alsem, Bettina Sandbergen, Karolijn Dulfer, Matthijs de Hoog, Koen F. M. Joosten, Clara D. van Karnebeek, Job B. M. van Woensel, Jolanda M. Maaskant

Publication

Journal: European Journal of pediatrics
Volume:
Issue:
Pages: -
Year: 2023
DOI: 10.1007/s00431-023-05049-2

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This project is made possible by the Foundation “Steun Emma Kinderziekenhuis” and The Netherlands Organization for Health Research and Development (ZonMw; 845008701). Both funders had no role in the design and conduct of the study.


Health Area

Disease Category: Child health, Effective practice/health systems

Disease Name: Complex medical needs

Target Population

Age Range: 0 - 18

Sex: Either

Nature of Intervention: Management of care

Stakeholders Involved

- Clinical experts
- Consumers (caregivers)
- Families
- Patient/ support group representatives

Study Type

- COS for clinical trials or clinical research
- COS for practice

Method(s)

- Delphi process
- Focus group(s)

The development process consisted of two phases: (1) a three-round Delphi study in which diferent professionals rated outcomes, previously described in a systematic review, for inclusion in the COS and (2) focus groups with parents of
CMC to validate the results of the Delphi study.