Bridging the treatment gap for young people living with OCD

An Australian-first paediatric public health service is helping to bridge the gap and advance treatment for young people living with obsessive-compulsive disorder (OCD). 

The OCD BOUNCE clinical service provides wrap-around clinical care and intensive treatment in community settings. It offers specialised training and support for clinicians to enable them to better detect and treat OCD in community mental health care.

OCD affects one in 50 children and young people in Australia and has the second-highest psychiatric hospital admission length of stay with the highest re-admission rates.

The service was born out of a broader national research collective, also called OCD BOUNCE, which brings together internationally recognised experts from The Sydney Children's Hospitals Network, University of NSW and Griffith University to advocate for, improve understanding and treatment of OCD...

Strengthening primary health care in children

Referrals to paediatric hospitals saw a 26% increase in 3 years and wait times for many conditions have risen to unsustainable levels, ultimately putting pressure on the hospital system.

The Strengthening Care for Children (SC4C) trial tested a model that brought together general practitioners (GPs) and pediatricians for 12 months to strengthen paediatric primary care across Sydney and Melbourne.

Results in publications from the SC4C trial indicated reduced hospital referrals especially among high-referring GPs by 4.5%. GPs also cited improved confidence and knowledge, and families expressed satisfaction with the shared knowledge and quality of care jointly delivered by GPs and paediatricians.

The same integrated GP-paediatrician model is being evaluated for virtual format to support urban and rural primary health care practices in NSW.

SC4C was kindly supported by the Sydney Children’s Hospitals Foundation and an NHMRC Partnership grant. It was led through the Population Child Health Research team at Kids Research.

Improving how we care for childhood asthma in hospital

Hospitalisation rates for children with asthma are over three times higher than adults, impacting up to 400,000 children across Australia. Clinical research initiatives like the ImpACT Childhood Asthma program aim to close the care gap for asthma patients being admitting to hospital, particularly patients re-admitted to hospital several times a year.

The program identified that less than 60% of asthma care in hospitals are guideline-adherent. On average 4-6 different asthma clinical practice guidelines and asthma action plans were used across local health districts and even departments in the same hospital. Asthma education in hospital was found often to be non-formal, with no system to ensure subsequent follow-ups after being discharged from hospital.

Based on this information, the program trialled an integrated comprehensive model of asthma care at the Sydney Children’s Hospital, Randwick. The model of care showed a 66% reduction in the number of children hospitalisations relating to asthma.

The program was kindly supported by NSW Ministry of Health, Asthma Australia, Rotary Club of Sydney Cove and Sydney Children’s Hospitals Foundation, and is led by Dr Nusrat Homaira part of the Respiratory Research Group at Kids Research.

Caring for childhood cancer survivors

Over 90% of childhood cancer survivors develop serious chronic health problems due their cancer and its treatment. Researchers at the Sydney Children’s Hospital, Randwick, trialled a comprehensive survivorship care intervention called 'Engage' to bridge the care gap for those impacted following their cancer treatment.

The virtually delivered intervention was found to significantly improve survivors’ confidence to manage their long-term survivorship needs, increase survivors’ satisfaction with care, and decrease survivors’ information needs and mental health concerns. The 'Engage' program has since been implemented as part of the services provided at the Kids Cancer Centre.

The research was delivered through the Behavioural Sciences Unit at Kids Research in collaboration with the University of NSW.

Novel anaesthesia strategies for infants

A novel general anaesthesia technique was trialled at The Children's Hospital at Westmead to explore a potential superior anaesthesia strategy for use in infants expected to have anaesthesia lasting two hours or longer.

The Trial Remifentanil DEXmedetomidine (T-REX) study was a multi-national randomised controlled trial that compared the standard-dose sevoflurane for general anesthesia to a novel low-dose sevoflurane approach supplemented with dexmedetomidine and remifentanil.

Early postoperative results of the study have suggested that the novel technique is clinically appropriate, sharing some profile similarities to the standard technique.

The initial short-term outcomes paper was published in the Anesthesiology, the top ranked anaesthesia journal globally, and was led by senior author Associate Professor Justin Skowno, through the Children's Perioperative Laboratory (ChiP) at Kids Research.

Supporting families and their children requiring wheelchairs

It can be distressing for children and their families living with neuromuscular conditions who require a wheelchair.

A team of clinician researchers at the Sydney Children’s Hospital, Randwick, led the co-design and evaluation of a tailored psycho-educational booklet called "Getting wheels" as an effective resource in introducing a wheelchair to impacted children.

The resource was trialled with both parents and clinicians and received overwhelming positive endorsements. The booklet addressed information and support needs of carers, and almost all parents who participated agreed it would help engage other parents in the wheelchair prescription process.

"Getting Wheels" has since been implemented within tertiary paediatric neuromuscular clinics across Australia and has recently been revised for a second version.

Published in Disability and Rehabilitation: Assistive Technology, the project was led by Sarah-Grace Paguinto through the Paediatric Neurology Research Group at Kids Research.

Ten-year collaboration advances heart research for children

Unexpected sudden cardiac arrests impact 2-3 young Australians every week and can strike out of the blue. While they are caused mostly by inherited arrhythmic and heart muscle diseases, the exact causes remain under researched.

Researchers and clinicians across The Sydney Children’s Hospitals Network investigated the causes of unexpected sudden cardiac arrest. The ten-year long research collaboration determined that CPVT (catecholaminergic polymorphic ventricular tachycardia) was the most common cause of sudden cardiac arrest in infants and children, occurring in approximately 1 in 45,000 live births. Previously, Long QT syndrome was the most common cause.

This collaboration was conducted through the Kids Heart Research team at Kids Research at the Inherited Arrhythmia Clinic with help from first responders and intensive care teams.

The team have since established a new Hypertrophic Cardiomyopathy Clinic to further advance their paediatric heart research.