The impact of a health care transition clinic on spina bifida condition management and transition planning.


Journal

Disability and health journal
ISSN: 1876-7583
Titre abrégé: Disabil Health J
Pays: United States
ID NLM: 101306633

Informations de publication

Date de publication:
10 2023
Historique:
received: 10 01 2023
revised: 05 07 2023
accepted: 07 07 2023
medline: 18 9 2023
pubmed: 5 8 2023
entrez: 4 8 2023
Statut: ppublish

Résumé

To better serve the growing population of individuals with spina bifida (SB) living into adulthood, pediatric SB clinics have developed structured health care transition (HCT) supports for adolescents and young adults. Evaluating the impact of structured HCT on SB-related chronic condition outcomes and transition planning goals is needed to assess such interventions. This study explored the impact of a SB HCT Clinic on SB-related chronic condition management outcomes (e.g., reported bowel and bladder regimens and presence of pressure injury) and transition planning goals (e.g., decision-making, insurance, and transportation). A retrospective chart review was conducted of young adults with SB who did and did not participate in an SB HCT Clinic before establishing an adult clinic to compare SB-condition outcomes and HCT planning goals between groups. Associations between demographic and clinical variables and outcomes were also assessed. The HCT group (n = 68) was more likely to use a bowel regimen (P < 0.01) compared to the non-HCT group (n = 94). There were no differences regarding bladder regimens or incidence of pressure injuries. For HCT planning, the groups differed regarding decision-making supports (P = 0.01). Additionally, the HCT group was more likely to use self-transportation (P = 0.01) or Medicaid transportation (P < 0.01). This single-center HCT program improved the use of a bowel regimen at the time of transfer to adult care and impacted HCT planning regarding decision-making and transportation. These initial findings support the need for further development and assessment of HCT programs for this population.

Sections du résumé

BACKGROUND
To better serve the growing population of individuals with spina bifida (SB) living into adulthood, pediatric SB clinics have developed structured health care transition (HCT) supports for adolescents and young adults. Evaluating the impact of structured HCT on SB-related chronic condition outcomes and transition planning goals is needed to assess such interventions.
OBJECTIVE
This study explored the impact of a SB HCT Clinic on SB-related chronic condition management outcomes (e.g., reported bowel and bladder regimens and presence of pressure injury) and transition planning goals (e.g., decision-making, insurance, and transportation).
METHODS
A retrospective chart review was conducted of young adults with SB who did and did not participate in an SB HCT Clinic before establishing an adult clinic to compare SB-condition outcomes and HCT planning goals between groups. Associations between demographic and clinical variables and outcomes were also assessed.
RESULTS
The HCT group (n = 68) was more likely to use a bowel regimen (P < 0.01) compared to the non-HCT group (n = 94). There were no differences regarding bladder regimens or incidence of pressure injuries. For HCT planning, the groups differed regarding decision-making supports (P = 0.01). Additionally, the HCT group was more likely to use self-transportation (P = 0.01) or Medicaid transportation (P < 0.01).
CONCLUSION
This single-center HCT program improved the use of a bowel regimen at the time of transfer to adult care and impacted HCT planning regarding decision-making and transportation. These initial findings support the need for further development and assessment of HCT programs for this population.

Identifiants

pubmed: 37541929
pii: S1936-6574(23)00080-8
doi: 10.1016/j.dhjo.2023.101508
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101508

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Sujal Manohar (S)

Student Affairs, Baylor College of Medicine, Houston, TX, USA. Electronic address: sujal.manohar@bcm.edu.

Kristen A Staggers (KA)

Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA.

Xiaofan Huang (X)

Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA.

Jonathan Castillo (J)

Texas Children's Spina Bifida Clinic, The Meyer Center for Developmental Pediatrics, Baylor College of Medicine, Houston, TX, USA.

Heidi Castillo (H)

Texas Children's Spina Bifida Clinic, The Meyer Center for Developmental Pediatrics, Baylor College of Medicine, Houston, TX, USA.

Ellen Fremion (E)

Texas Children's Spina Bifida Clinic, The Meyer Center for Developmental Pediatrics, Baylor College of Medicine, Houston, TX, USA; Department of Medicine, Section of Transition Medicine, Baylor College of Medicine, Houston, TX, USA.

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Classifications MeSH