Differences in Healthcare Transition Views, Practices, and Barriers Among North American Pediatric Rheumatology Clinicians From 2010 to 2018.

Autor:	Johnson KR; K.R. Johnson, PhD, MSEd, MPH, Department of Pediatrics, East Tennessee State University, Johnson City, Tennessee; Johnsonkr3@etsu.edu., Edens C; C. Edens, MD, Departments of Medicine and Pediatrics, Sections of Rheumatology and Pediatric Rheumatology, University of Chicago, Chicago, Illinois., Sadun RE; R.E. Sadun, MD, PhD, Departments of Medicine and Pediatrics, Divisions of Rheumatology, Duke University Medical Center, Durham, North Carolina., Chira P; P. Chira, MD, Pediatric Rheumatology, University of California San Diego, Rady Children's Hospital, San Diego, California., Hersh AO; A.O. Hersh, MD, Division of Pediatric Rheumatology, University of Utah, Salt Lake City, Utah., Goh YI; Y.I. Goh, BS, Division of Rheumatology/Pediatrics, The Hospital for Sick Children, and Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada., Hui-Yuen J; J. Hui-Yuen, MD, MSc, FACR, FAAP, Pediatric Rheumatology, Cohen Children's Medical Center, New Hyde Park, New York., Singer NG; N.G. Singer MD, Departments of Medicine and Pediatrics, Division of Rheumatology, Metrohealth System and Case Western Reserve University School of Medicine, Cleveland, Ohio., Spiegel LR; L.R. Spiegel, MD, FRCPC, Division of Pediatrics/Rheumatology, University of Utah, Salt Lake City, Utah, USA, and Division of Rheumatology/Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada., Stinson JN; J.N. Stinson, RN-EC, PhD, CPNP, Division of Rheumatology/Pediatrics, The Hospital for Sick Children, and Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada., White PH; P.H. White, MD, MA, FACP, FAAP, Got Transition, and Department of Medicine, Division of Rheumatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA., Lawson E
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2021 Sep; Vol. 48 (9), pp. 1442-1449. Date of Electronic Publication: 2021 Feb 01.
DOI:	10.3899/jrheum.200196
Abstrakt:	Objective: Since 2010, the rheumatology community has developed guidelines and tools to improve healthcare transition. In this study, we aimed to compare current transition practices and beliefs among Childhood Arthritis and Rheumatology Research Alliance (CARRA) rheumatology providers with transition practices from a provider survey published in 2010. Methods: In 2018, CARRA members completed a 25-item online survey about healthcare transition. Got Transition's Current Assessment of Health Care Transition Activities was used to measure clinical transition processes on a scale of 1 (basic) to 4 (comprehensive). Bivariate analyses were used to compare 2010 and 2018 survey findings. Results: Over half of CARRA members completed the survey (202/396), including pediatric rheumatologists, adult- and pediatric-trained rheumatologists, pediatric rheumatology fellows, and advanced practice providers. The most common target age to begin transition planning was 15-17 years (49%). Most providers transferred patients prior to age 21 years (75%). Few providers used the American College of Rheumatology transition tools (31%) or have a dedicated transition clinic (23%). Only 17% had a transition policy in place, and 63% did not consistently address healthcare transition with patients. When compared to the 2010 survey, improvement was noted in 3 of 12 transition barriers: availability of adult primary care providers, availability of adult rheumatologists, and pediatric staff transition knowledge and skills ( P < 0.001 for each). Nevertheless, the mean current assessment score was < 2 for each measurement. Conclusion: This study demonstrates improvement in certain transition barriers and practices since 2010, although implementation of structured transition processes remains inconsistent. (© 2021 by the Journal of Rheumatology.)
Databáze:	MEDLINE
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