Epilepsy: Transition from pediatric to adult care. Recommendations of the Ontario epilepsy implementation task force

Autor: Beverly Guttman, Laurene Sellers, Lezlee Lindzon, Peter Szatmari, Timothy Gofine, Rosie Smith, Tracy Nejm, Anne S. Bassett, Mary Secco, Bernard Lawless, O. Carter Snead, Mary Pat McAndrews, Ayman Hassan, Peter Camfield, Danielle M. Andrade, Marie Slegr, Lisa Graves, Maya Guttman-Slater, Berge A. Minassian, Lysa Boissé Lomax, Rima Nabbout, Michelle Shapiro, Dolly Menna-Dack, Eyal Cohen, Megan Henze, Esther Bui, Jon Greenaway, Janice Mulligan, Anastasia Vogt, Sharon Whiting, Guida Quaglia Clozza, Miriam Kaufman, Felippe Borlot, Leeping Tao, Eduard Bercovici, Hannah Lee
Rok vydání: 2017
Předmět:
Zdroj: Epilepsia. 58(9)
ISSN: 1528-1167
Popis: The transition from a pediatric to adult health care system is challenging for many youths with epilepsy and their families. Recently, the Ministry of Health and Long-Term Care of the Province of Ontario, Canada, created a transition working group (TWG) to develop recommendations for the transition process for patients with epilepsy in the Province of Ontario. Herein we present an executive summary of this work. The TWG was composed of a multidisciplinary group of pediatric and adult epileptologists, psychiatrists, and family doctors from academia and from the community; neurologists from the community; nurses and social workers from pediatric and adult epilepsy programs; adolescent medicine physician specialists; a team of physicians, nurses, and social workers dedicated to patients with complex care needs; a lawyer; an occupational therapist; representatives from community epilepsy agencies; patients with epilepsy; parents of patients with epilepsy and severe intellectual disability; and project managers. Three main areas were addressed: (1) Diagnosis and Management of Seizures; 2) Mental Health and Psychosocial Needs; and 3) Financial, Community, and Legal Supports. Although there are no systematic studies on the outcomes of transition programs, the impressions of the TWG are as follows. Teenagers at risk of poor transition should be identified early. The care coordination between pediatric and adult neurologists and other specialists should begin before the actual transfer. The transition period is the ideal time to rethink the diagnosis and repeat diagnostic testing where indicated (particularly genetic testing, which now can uncover more etiologies than when patients were initially evaluated many years ago). Some screening tests should be repeated after the move to the adult system. The seven steps proposed herein may facilitate transition, thereby promoting uninterrupted and adequate care for youth with epilepsy leaving the pediatric system.
Databáze: OpenAIRE