Outcomes following a multi-disciplinary pediatric-to-adult transition and transfer clinic at a level four epilepsy center.
clinic model
epilepsy transition clinic model
multidisciplinary transition clinic
transition clinic outcomes
transition clinic results
transition of care
Journal
Epileptic disorders : international epilepsy journal with videotape
ISSN: 1950-6945
Titre abrégé: Epileptic Disord
Pays: United States
ID NLM: 100891853
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
revised:
14
12
2022
received:
23
03
2022
accepted:
26
12
2022
medline:
1
6
2023
pubmed:
21
3
2023
entrez:
20
3
2023
Statut:
ppublish
Résumé
Transition and transfer from the pediatric to adult care model is crucial to the continued long-term health and well-being of patients impacted by life-long diseases. This project explores the impact of a novel epilepsy transition collaboration between Nationwide Children's Hospital (NCH) and Ohio State University (OSU) Wexner Medical Center. We retrospectively analyzed the characteristics and outcomes of 56 consecutive patients transferred to an adult health care system. These patients were divided into two groups. A cohort of 23 patients transferred in 2019 prior to clinic implementation were compared to a cohort of 33 consecutive patients transferred in 2019 and early 2020 using the epilepsy transition and transfer clinic model. Data points of interest included demographic information, age at transfer, epilepsy diagnosis, pharmacoresistance of epilepsy, surgical history and compliance with follow-up. Patients transferred to OSU through the transition clinic were statistically more likely to be followed at OSU (p = .037) within 6 months (p = .013). Additionally, there was improved patient retention at OSU following transition clinic implementation (p = .037). Data demonstrating statistically significant improvement in care has not been reported for an epilepsy transition clinic. This study establishes that our novel approach improves continuity of care in this at-risk population. Our clinic model also successfully transitioned and transferred medically complex patients, including those with pharmacoresistant and/or genetically mediated epilepsy. Additionally, this work suggests that this clinic structure has potential to foster the growth of associated adult epilepsy subspecialty practices. These findings are encouraging as they offer potential for improved health care in the youth and young adult epilepsy population.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
255-261Informations de copyright
© 2023 International League Against Epilepsy.
Références
Transition of care provided for adolescents with special health care needs. American Academy of Pediatrics Committee on Children with Disabilities and Committee on Adolescence. Pediatrics. 1996;98(6 Pt 1):1203-1206.
Camfield PR, Camfield CS. What happens to children with epilepsy when they become adults? Some facts and opinions. Pediatr Neurol. 2014;51(1):17-23.
Lewis SA, Noyes J. Effective process or dangerous precipice: qualitative comparative embedded case study with young people with epilepsy and their parents during transition from children's to adult services. BMC Pediatr. 2013;13:169.
Geerlings RP, Aldenkamp AP, Gottmer-Welschen LM, de With PHN, Zinger S, van Staa AL, et al. Evaluation of a multidisciplinary epilepsy transition clinic for adolescents. Eur J Paediatr Neurol. 2016;20(3):385-92.
Child and Adolescent Health Measurement Initiative [2009/10 NS-CSHCN: Condition-Specific Profile Nationwide Epilepsy or seizure disorder]. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). www.childhealthdata.org. Accessed 27 May 2020.
Camfield C, Camfield P. Twenty years after childhood-onset symptomatic generalized epilepsy the social outcome is usually dependency or death: a population-based study. Dev Med Child Neurol. 2008;50(11):859-63.
Twanow JE, Maturu S, Khandker N. Pediatric to adult epilepsy transition in ambulatory care: benefits of a multidisciplinary epilepsy transition clinic. J Pediatr Epilepsy. 2020;9(4):125-34.
Clark SJ, Beimer NJ, Gebremariam A, Fletcher LL, Patel AD, Carbone L, et al. Validation of EpiTRAQ, a transition readiness assessment tool for adolescents and young adults with epilepsy. Epilepsia Open. 2020;5(3):487-95.
Boyce DM, Devinsky O, Meskis MA. Barriers to transition from pediatric to adult care for patients with Dravet syndrome: a focus group study of caregivers. Epilepsy Behav. 2020;109:107096.
Hardin AP, Hackell JM, MEDICINE COPAA. Age limit of pediatrics. Pediatrics. 2017;140:3.
Nabbout R, Teng T, Chemaly N, Breuillard D, Kuchenbuch M. Transition of patients with childhood onset epilepsy: perspectives from pediatric and adult neurologists. Epilepsy Behav. 2020;104:106889.
Borlot F, Tellez-Zenteno JF, Allen A, Ali A, Snead OC, Andrade DM. Epilepsy transition: challenges of caring for adults with childhood-onset seizures. Epilepsia. 2014;55(10):1659-66.
Camfield P, Camfield C, Pohlmann-Eden B. Transition from pediatric to adult epilepsy care: a difficult process marked by medical and social crisis. Epilepsy Curr. 2012;12(3):13-21.
Nabbout R, Arzimanoglou A, Chin RFM, Grinspan Z, Speechley K, Camfield P. The evaluation and costs of transition programs for youth with epilepsy. Epilepsy Behav. 2019;93:133-7.
Jones MR, Hooper TJ, Cuomo C, Crouch G, Hickam T, Lestishock L, et al. Evaluation of a health care transition improvement process in seven large health care systems. J Pediatr Nurs. 2019;47:44-50.
Obiako OR, Sheikh TL, Kehinde JA, Iwuozo EU, Ekele N, Elonu CC, et al. Factors affecting epilepsy treatment outcomes in Nigeria. Acta Neurol Scand. 2014;130(6):360-7.
Minshall I, Neligan A. A review of people who did not attend an epilepsy clinic and their clinical outcomes. Seizure. 2017;50:121-4.
Nelson EA, Maruish ME, Axler JL. Effects of discharge planning and compliance with outpatient appointments on readmission rates. Psychiatr Serv. 2000;51(7):885-9.
Nuti LA, Lawley M, Turkcan A, Tian Z, Zhang L, Chang K, et al. No-shows to primary care appointments: subsequent acute care utilization among diabetic patients. BMC Health Serv Res. 2012;12:304.
Moore CG, Wilson-Witherspoon P, Probst JC. Time and money: effects of no-shows at a family practice residency clinic. Fam Med. 2001;33(7):522-7.
Kang PB, Bale JF, Mintz M, Joshi SM, Gilbert DL, Radabaugh C, et al. The child neurology clinical workforce in 2015: report of the AAP/CNS joint taskforce. Neurology. 2016;87(13):1384-92.
Bale JF, Currey M, Firth S, Larson R, Society ECotCN. The child neurology workforce study: pediatrician access and satisfaction. J Pediatr. 2009;154(4):602-6.e1.