Health Care Transitions最新文献

{"title":"Development of the iManage SCD mobile health application for transition","authors":"Caren Steinway ,&nbsp;Steffi Shilly ,&nbsp;Tanisha Belton ,&nbsp;Kim Smith-Whitley ,&nbsp;Sophia Jan ,&nbsp;Lisa A. Schwartz ,&nbsp;Lori E. Crosby","doi":"10.1016/j.hctj.2024.100074","DOIUrl":"10.1016/j.hctj.2024.100074","url":null,"abstract":"<div><h3>Objective</h3><div>This paper outlines the design and implementation of iManage SCD, a self-management mobile health application for adolescents and young adults (AYA) with sickle cell disease (SCD) during transition from pediatric to adult health care.</div></div><div><h3>Methods</h3><div>The Integrate, Design, Assess, Share (IDEAS) framework, emphasizing user insights, iterative design, rigorous assessment, and knowledge sharing, guided the development process. The design team consisted of researchers, psychologists, physicians, social workers, AYA with SCD, and parents of AYA with SCD (n = 16) across three states. Qualitative focus groups and interviews were conducted and analyzed using thematic analysis across the integrate and design phases. Point of use feedback from AYA with SCD was used to assess feasibility and acceptability.</div></div><div><h3>Results</h3><div>The development process was centered around tenants of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition. Development integrated multidisciplinary perspectives, fostering a person-centered approach. The iterative design process involved collaboration with a digital health firm, Agency39A. Health equity and implementation considerations were addressed at individual, community, and healthcare system levels. Themes that emerged from focus groups with AYA, clinicians, and researchers in the integrate and design phases of development included recommendations for content and user experience features.</div></div><div><h3>Conclusions</h3><div>iManage SCD emerges as a comprehensive, user-friendly mobile health application, incorporating theoretical principles and direct user input. The development process demonstrated feasibility and acceptability, and the paper discusses dissemination strategies for the Community Health Workers and Mobile Health Programs to Help Young Adults with SCD Transition to Using Adult Healthcare Services (COMETS) study.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a transition program for emerging adults with type 1 diabetes: A quality improvement initiative","authors":"Elizabeth A. Minchau ,&nbsp;Billie S. Vance ,&nbsp;Emily Barnes","doi":"10.1016/j.hctj.2024.100073","DOIUrl":"10.1016/j.hctj.2024.100073","url":null,"abstract":"<div><h3>Background</h3><div>Emerging adults with type 1 diabetes (T1D) struggle with glycemic management that can be exacerbated by a disorganized transition process. Substantial gaps in care have been noted during this transition period and have been shown to lead to suboptimal health care utilization, worsening glycemic management, increased incidence of serious complications, and mental health challenges. A formal transition program can help prevent gaps in care, improve disease self-management skills, decrease disease burden, and reduce diabetes complications.</div></div><div><h3>Purpose</h3><div>There is an increased focus within the pediatric community to formally prepare young adults with T1D as they transition to the adult health care setting. The purpose of the quality improvement initiative was to develop a transition program for adolescents with T1D in a pediatric endocrinology clinic within an academic medical center.</div></div><div><h3>Methods/interventions</h3><div>The Institute for Healthcare Improvement <em>Model for Improvement</em> was used to guide this project. Got Transition's® <em>Six Core Elements of Health Care Transition</em> were adapted to the unique needs of the pediatric endocrinology setting by incorporating diabetes-specific transition guidelines recommended by the American Diabetes Association (ADA). A new program was designed to target patients between the ages of 16–18 offering structured transition visits focused on enhancing knowledge and skills related to the management of T1D and improving the transfer of care process between pediatric and adult providers. Key elements of the program were integrated into the electronic health record. A focus group with clinical partners was used to evaluate the acceptability and practicality of the program.</div></div><div><h3>Results</h3><div>Transition activity within the clinic increased from 12/32–28/32 on the <em>Current Assessment of Healthcare Transition Activities</em> tool. Four themes were identified from clinical partner feedback supporting the acceptability and practicality of program design.</div></div><div><h3>Conclusions</h3><div>The integration of the Got Transition® framework and the ADA recommendations supports clinicians in meeting the unique needs of adolescents with T1D. Incorporating the transition activities into the electronic health record facilitated integration into the workflow of the clinic providers. This initiative can serve as a model to expand transition activities across pediatric specialty care settings.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of characteristics amongyoungpeople discharged from adolescent medium secure psychiatric hospital","authors":"Charlotte A. Jones ,&nbsp;Simon A Hill ,&nbsp;Louise Dibben ,&nbsp;Sana Sajid ,&nbsp;Suchith Shetty ,&nbsp;Selma Majeed ,&nbsp;Peter Phiri","doi":"10.1016/j.hctj.2024.100047","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100047","url":null,"abstract":"<div><h3>Background</h3><p>Specialised forensic mental health provision for young people with mental disorders and high-risk behaviours has developed significantly in the UK. Despite this, research on the young people within secure settings remains limited. Adolescents in secure settings exhibit higher levels of mental disorders and have complex needs. This study aims to compare the demographic characteristics of patients discharged from an adolescent medium secure unit (AMSU) to different discharge destinations: community, another hospital, or custodial setting.</p></div><div><h3>Methods</h3><p>A retrospective study was conducted using data from 155 patients admitted to a UK AMSU from 2008 to 2021. Demographic data, clinical information and Millon Adolescent Clinical Inventory (MACI) scores were extracted from electronic health records. A descriptive statistical method was used to report observational differences in patient characteristics between discharge locations. Statistical analysis included Chi-squared tests and AVOVA testing.</p></div><div><h3>Results</h3><p>Patients discharged to different settings exhibited distinct demographic and clinical characteristics. Those discharged to custodial settings were predominantly male and often transferred from custodial settings. Those discharged to other hospitals were mostly females with a diagnosis of Borderline Personality Disorder. The community-discharged group had a higher frequency of admissions from other hospitals under civil sections. Multiple variables were found to be statistically significant in relation to discharge location including gender and age at discharge. Findings of the MACI were not statistically significant in relationship with discharge location.</p></div><div><h3>Conclusions</h3><p>The study enhances understanding of healthcare transitions from AMSUs. The influence of diagnoses, particularly personality disorders, and their connection to admission duration is explored, as is the influence of this on transitioning patients across care settings. The impact of trauma-informed, attachment focussed models of care in regards transitions from AMSUs is also examined. Despite diversity in discharge locations, self-reported personality questionnaires show consistent outcomes, demonstrating psychological similarities across groups. Further research is needed to understand post-discharge trajectories enabling targeted interventions and improved care pathways.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000072/pdfft?md5=890c21d52881a60dfbece034d1941819&pid=1-s2.0-S2949923224000072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric urology patient transition to adulthood: Brief report on the barriers and shortcomings in a resource poor state","authors":"Victor C. Showalter,&nbsp;Angela C. Salazar,&nbsp;Jason M. Wilson,&nbsp;Jessica M. Ming","doi":"10.1016/j.hctj.2024.100062","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100062","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>To evaluate the readiness of pediatric spina bifida (SB) patients to transition from pediatric to adult urologic care. Since 1975 the survival rate of SB has increased from less than 50 % to 85 %. Adult SB patients have increased urologic needs due to their increased risk of complications including: 7–11 times risk of renal failure, 2 times risk of bladder cancer, and 46 times risk likely of UTIs. These SB complications resulted in 37,000 hospitalization from 2004–2005 with one third of those being deemed preventable. Research has shown that adult SB patients who have successfully transitioned to adult care utilize less care 5.33 annual ambulatory visits compared to 7.25 in the non-transitioned counterparts. Our goal is to evaluate barriers, concerns, and comfort in skills deemed necessary for an SB patient’s successful transition to adult care in a resource poor state.</p></div><div><h3>Material and Methods</h3><p>All SB patients between the ages of 12–18 who participate in the multidisciplinary clinic and are seen by urology at UNM were eligible and offered to complete a questionnaire prior to their clinic visit. The questionnaire addressed awareness, fears and desire to learn about transitioning.</p></div><div><h3>Results</h3><p>Of the SB patients that were eligible for the study 10 have filled out the survey. The average age is 17.7. While 70 % know the meaning of transition, only 40 % have thought about the process. 70 % of patients believe the best age to transition is 19–21. The most prominent fears about transition included leaving current urologist (60 %), increasing responsibility for their own care (50 %), and the new urologist not knowing their past medical history (50 %) (Fig 1). Questions evaluating preferred method transition education 60 % preferred talking with the pediatric urologist, and marked they would like to meet with the pediatric urologist and adult urologist simultaneously.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000229/pdfft?md5=68601c18d533ca72ae70c8380a82f09c&pid=1-s2.0-S2949923224000229-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letting go/ moving on: A scoping review of relational effects on transition to adult care","authors":"Susan Shanske ,&nbsp;Janis Arnold ,&nbsp;Judy Bond ,&nbsp;Jennifer Cuadra ,&nbsp;Colleen Hayden ,&nbsp;Lynne Helfand ,&nbsp;Salihah Hanson ,&nbsp;Teresa Hickam ,&nbsp;Colleen Huysman ,&nbsp;Alexandria Cronin","doi":"10.1016/j.hctj.2024.100068","DOIUrl":"10.1016/j.hctj.2024.100068","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this scoping review was to assess the extent of the literature on how relational components in pediatric care contribute to the transition process and transfer outcomes.</p></div><div><h3>Background</h3><p>Relationships between patients, parents and pediatric providers are a frequently cited barrier in transition to adult care. A scoping review aimed to identify studies focused on how the relationship between patients/parents and pediatric providers related to transition from pediatric to adult healthcare and explore the nature and depth of the evidence.</p></div><div><h3>Methods</h3><p>Search terms were identified through a combination of medical librarian term harvesting and expert input. Four databases were searched with a combination of keyword and controlled vocabulary: PubMed, CINAHL, PsycINFO, and Web of Science. In order to reduce the risk of bias, each record was reviewed by two independent clinical experts in both the screening and full-text review stages. No database filters were applied during the searching process.</p></div><div><h3>Results</h3><p>The initial search strategy resulted in 13,121 records. After removal of duplicates, 271 moved on to full text review, and 152 met inclusion criteria as related to both transition from pediatric to adult medical care and relationships between pediatric providers and patients/families.</p></div><div><h3>Conclusions</h3><p>This scoping review aimed to identify available literature on relationships between pediatric providers and patients/families. Variable levels of research were identified, with little formal study of interventions. The majority described relationship issues as barriers, either on the part of providers, patients, parents or a combination of these. Several highlighted relationship ties as facilitators in the transition, an important consideration in determining interventions.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294992322400028X/pdfft?md5=7dabc5faa06e4fdbea540dd40ddbdc57&pid=1-s2.0-S294992322400028X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating vocational supports into a transition clinic: A pilot program","authors":"Elijah W. Hale ,&nbsp;Aryn Taylor ,&nbsp;Marlee Elton ,&nbsp;Melanie Honsbruch ,&nbsp;Cordelia Robinson Rosenberg ,&nbsp;Jessica Solomon Sanders","doi":"10.1016/j.hctj.2024.100048","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100048","url":null,"abstract":"<div><h3>Objective</h3><p>Pilot a clinical model and study to learn more about how employment impacts health in children and young adults with intellectual and developmental disabilities.</p></div><div><h3>Background</h3><p>As young individuals transition into adulthood, milestones such as independent living and gainful employment become paramount. However, for those with intellectual and developmental disabilities (IDD), these milestones can diverge notably from those of typically developing peers. They often confront distinct challenges, especially during shifts from pediatric to adult health care and transitioning from school to employment. Despite the positive influence of employment on quality of life, fragmented support systems create barriers to achieving this outcome. Employment is an important aspect of overall health and wellness, and more research is needed to determine how employment supports can be integrated with health care to improve certain health outcomes.</p></div><div><h3>Design</h3><p>Self-determination theory and social ecological theory highlight the need for a comprehensive approach that considers both the internal needs and motivations of the individual with IDD and the external factors that influence their transition to adulthood. Based in these theories, our intervention offers an innovative blend of vocational support within a transition services framework at a large academic hospital. Our study introduces vocational support tailored for IDD youths within three health clinics.</p></div><div><h3>Results</h3><p>Initial results demonstrate the technical and scheduling feasibility of integrating the intervention within existing healthcare services. The study has enrolled several participants, showing potential in technical, scheduling, economic, and operational domains. However, upcoming long-term data and comprehensive evaluation are required for a conclusive understanding of the intervention's impact.</p></div><div><h3>Conclusions</h3><p>The program integrates vocational support into transitioning individuals with IDD from childhood to adult health care services. This intervention has potential to improve the health outcomes and quality of life for individuals with IDD, which could drive broader interdisciplinary interventions.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000084/pdfft?md5=18f34267149f0529fc924b63163e7de3&pid=1-s2.0-S2949923224000084-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139976109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a transition workshop for adolescents with sickle cell disease","authors":"James Bradley ,&nbsp;Zelyn Lee ,&nbsp;Melina Cheong","doi":"10.1016/j.hctj.2023.100040","DOIUrl":"https://doi.org/10.1016/j.hctj.2023.100040","url":null,"abstract":"<div><h3>Background</h3><p>The transfer from paediatric to adult care presents a significant challenge for adolescents and young adults (AYA) with sickle cell disease (SCD). Disease self-management skills have been recognized as important mediators of poor health outcomes, but transition-related skills such as scheduling appointments and understanding the shift in health care responsibilities remain under taught in the healthcare system. The purpose of this quality improvement (QI) study was to (1) understand the areas of disease self-management that AYA patients felt underprepared for, and (2) design and evaluate an educational program addressing the top unmet skills.</p></div><div><h3>Methods</h3><p>The Plan-Do-Study-Act (PDSA) model was implemented in a tertiary outpatient clinic between September 2020 and July 2021. Patients were surveyed during regular clinic visits to identify their priorities on disease self-management skills. Based on the results, a virtual workshop was created and administered three separate times. Feedback was collected using an electronic survey.</p></div><div><h3>Results</h3><p>‘Navigating the adult health care system’ was the top self-management skill that AYA patients (n = 39) identified needing more support with. The majority of participants (79%, n = 14) reported that the virtual workshop was excellent, with ‘appointment management’ being the most useful topic discussed. Participants also reported feeling more confident (71%) and aware (86%) of how to navigate adult care.</p></div><div><h3>Conclusion</h3><p>This QI study showed that delivering a virtual workshop on transition skills was well received by AYA participants with SCD. The PDSA framework was useful for identifying specific knowledge gaps in transition aged AYA to help improve patient education in a well-established transition program.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923223000405/pdfft?md5=7d465ef7d6615ab17fad2f66509cb045&pid=1-s2.0-S2949923223000405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139434544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the complex care landscape: Addressing challenges and advancing adult care frameworks for individuals with cerebral palsy","authors":"Jensine’ Clark ,&nbsp;Cristina Sarmiento ,&nbsp;Jessica Sanders ,&nbsp;Lauren Wang ,&nbsp;Lauren Fetsko ,&nbsp;Unoma Akamagwuna","doi":"10.1016/j.hctj.2024.100051","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100051","url":null,"abstract":"<div><p>Despite cerebral palsy (CP) being the most common motor disability in childhood, there are more adults living with CP than children. The necessitates a systematic approach to the care of adults with CP. This perspective piece presents the complex nature of a lifespan approach to the care of a childhood-onset disability. We share the multidisciplinary considerations from a primary care model to address chronic health conditions and preventive care. We also present a care model with an emphasis on Neurology and Neurodevelopmental Disability with its implications for adults with CP. Finally, we advocate for a care model that encompasses a biopsychosocial approach to treatments and interventions with essential elements that include the adult perspective.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000114/pdfft?md5=7ce7cd79b7bd9838b9f6f23ef76e2038&pid=1-s2.0-S2949923224000114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139908121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care transition experiences of young adults with medical complexity","authors":"Rhonda G. Cady ,&nbsp;Tori Bahr ,&nbsp;Carrie Au-Yeung ,&nbsp;Sera Kinoglu ,&nbsp;Megan Lutz ,&nbsp;Mark Jankowski","doi":"10.1016/j.hctj.2024.100070","DOIUrl":"10.1016/j.hctj.2024.100070","url":null,"abstract":"<div><h3>Background</h3><p>Transition from pediatric to adult healthcare and services is an important event in the life course of all youth, including youth living with medical complexity. Data from the National Survey of Children’s Health indicates less than 20 % of youth receive health care transition services. The goal of our study was understanding the support, tools and resources that facilitate successful health care transition of young adults living with medical complexity.</p></div><div><h3>Methods</h3><p>Young adults living with medical complexity and their parents shared their lived experience of ‘what worked’ and ‘what is needed’ for successful health care transition during focus group sessions. Content analysis of transcripts used an iterative and deductive approach guided by a priori themes.</p></div><div><h3>Findings</h3><p>The voices of ten young adults and fourteen parents were shared during three virtual focus group sessions. They described health care transition (HCT) as an individualized process with success relying on consistent, clearly-defined and systemwide guidelines and resources. Moving from pediatric/family-focused care to adult/patient-focused care requires increased self-management and young adults often felt under-prepared for this role. Support from formal transition coordinators would improve communication between the multiple health, county/state agency and education systems involved during the transition period.</p></div><div><h3>Conclusions</h3><p>Understanding the support, tools, and resources specifically needed by young adults with medical complexity for successful pediatric to adult health care transition is a critical first step in addressing the documented lack of transition services for this vulnerable population. This includes formal peer support programs for young adults with medical complexity and their parents.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000308/pdfft?md5=80476fcfd536a59520ef8c2ac7e06719&pid=1-s2.0-S2949923224000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142150001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the transition of adolescents and young adults with palliative care needs from pediatric to adult care","authors":"Emma W. Healy ,&nbsp;Natasha Z. Piracha","doi":"10.1016/j.hctj.2024.100072","DOIUrl":"10.1016/j.hctj.2024.100072","url":null,"abstract":"<div><h3>Background</h3><p>The transition from pediatric to adult healthcare poses significant challenges for adolescents and young adults (AYA), especially those with chronic conditions, yet most children receive inadequate transition preparation. Research on the transition for patients receiving palliative care services is particularly limited. We sought to address this gap in the literature.</p></div><div><h3>Methods</h3><p>Young adults aged 18 to 35 years who transitioned from the pediatric setting and received adult palliative care services at an urban academic medical center between the dates of February 1st_, 2020 and July 1st, 2022 were identified retrospectively via electronic medical record. Chart review was used to investigate outcomes of interest, including use of pediatric palliative care services and timing of care conversations.</p></div><div><h3>Results</h3><p>Only 23 % of patients interfaced with pediatric palliative care, despite all having childhood diagnoses. Pediatric palliative care exposure was associated with a significantly earlier median age of first adult palliative care encounter (19.63 versus 25.06, p = &lt;0.001). Goals of care discussions, code status conversations, and healthcare proxy documentation occurred earlier if pediatric palliative care was involved (18.9 years versus 25.7 years, p &lt; 0.001; 20.9 years versus 30.0 years, p &lt; 0.001; 20.7 versus 28.9, p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Pediatric palliative care services were underutilized in AYA patients, but when used, were associated with earlier adult palliative care encounters, goals of care discussions, code status decisions, and health care proxy identification.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000321/pdfft?md5=3220ceff60f54c5dbfb393cdaefa750a&pid=1-s2.0-S2949923224000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}