Abstract Rationale Children with difficult to treat asthma are characterized by high morbidity and healthcare burden. The Complex Asthma Multi-Disciplinary Team (CAMDT) meeting was established at Queensland Children’s Hospital to deliver coordinated, multidisciplinary management to this specific at-risk group. This study evaluated the impact of initial children managed via this MDT meeting pathway with respect to outcomes reflecting healthcare burden. Methods A retrospective chart review of data was from the Electronic Medical Record was conducted for pediatric patients (aged 5–16 years) enrolled in the CAMDT with 12 months of available follow up data. Healthcare burden outcome measures assessed included corticosteroid exposure, salbutamol prescription, ED visits, hospital admission frequence, hospital admission days, and ICU days. Patient engagement across allied-health services within the CAMDT during the 12-month post period was also recorded. Each patient’s “Time 0” was defined as the first encounter with the CAMDT. Baseline and post periods data reflected 12-month periods before and after Time 0. Due to non-parametric distribution of data, clinical outcomes were compared as follows: Continuous pre/post measures using the Wilcoxon Signed-Rank test; change in presence of any admission using the McNEmar exact binomial test; and change in admission burden among patient with any admissions using Wilcoxon Signed-rank test. Results 12 patients with complete 12 months of data available post MDT initial encounter were identified. Following CAMDT enrolment, consistent numerical improvements were observed across nearly all outcome measures (Table 1). Corticosteroid exposure and total days of hospital admissions showed statistically significant improvement. The proportion of patients with a reduction in numerical values for each outcome measure was 50% for all outcome measures apart from ICU days. Ongoing MDT engagement was high with 9 of 12 (75%) patients attending appointments with ≥2 allied health services outside of the CAMDT meetings (8 psychology, 6 speech pathology, 5 physiotherapy, and 7 allergy/immunology). Conclusions Enrollment in the complex asthma multidisciplinary team service was associated with reduced corticosteroid exposure and duration of hospital admission, despite small sample size. These initial findings support the value of a specific coordinated MDT approach to care in complex pediatric asthma. This abstract is funded by: None
Lantz et al. (Fri,) studied this question.