Transition Guide Dissemination to Foster Patient-Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study.

Autor: Chang JC; Boston Children's Hospital, Boston, Massachusetts and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Alonzi G; Boston Children's Hospital, Boston, Massachusetts., Sears C; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Bitencourt N; Loma Linda University Medical Center, Loma Linda, California., Hernandez A; Scottish Rite for Children, Dallas, Texas., Peterson R; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania and Dell Children's Medical Center, Austin, Texas., Alperin R; New York University Langone Health, New York, New York., Overbury RS; University of Utah, Salt Lake City, Utah., Dela Paz M; University of California San Francisco, San Francisco, California., Waqar-Cowles LN; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., White PH; Got Transition/The National Alliance to Advance Adolescent Health and The George Washington University, Washington, District of Columbia., Carandang K; Young Patients' Autoimmune Research & Empowerment Alliance, San Diego, California., Lawson EF; University of California San Francisco, San Francisco, California.
Jazyk: angličtina
Zdroj: ACR open rheumatology [ACR Open Rheumatol] 2025 Jan; Vol. 7 (1), pp. e11753. Date of Electronic Publication: 2024 Oct 09.
DOI: 10.1002/acr2.11753
Abstrakt: Objective: Uptake of evidence-informed health care transition processes among pediatric rheumatologists is low despite poor outcomes of transition from pediatric to adult care. We piloted a learning collaborative model to implement transition guides. We dually assessed implementation outcomes and changes in reported patient-care team discussions about transition.
Methods: This was a type II hybrid effectiveness-implementation pilot study of transition guide dissemination to patients at least 14 years old with rheumatic conditions across nine pediatric rheumatology centers in the Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative. We evaluated implementation outcomes (feasibility, adaptations, and fidelity) and the proportion of patients surveyed that reported having discussions with their care team regarding transfer planning.
Results: Six sites were retained through the COVID-19 pandemic (below 70% target). Five out of six sites contributed outcome data (met 80% target) but with substantial heterogeneity in how transition guides were shared (eg, in-person, electronic messages, and posted flyers), and data were collected. The pooled proportion of respondents having discussed transfer planning with their care team was 39% preimplementation (n = 239; 95% confidence interval [CI] 32%-46%) and 55% postimplementation (n = 864; 95% CI 36%-73%). After implementation, there were significant increases in the likelihood of respondents recalling receiving a transition guide (odds ratio [OR] 2.58, 95% CI 1.35-4.92) and discussing transfer planning (OR 2.14, 95% CI 1.30-3.52), adjusted for age and site of care.
Conclusion: Transition guide dissemination is a simple intervention associated with increased awareness among young people with rheumatic conditions and discussions with their care team about transition preparation. The learning collaborative model facilitated identification of several dissemination strategies adaptable to site-specific resources.
(© 2024 The Author(s). ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE