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Devaux F, Fonteyne C, Deriez M, Lambotte I. [Crossed perspectives on pediatrics to adult health care transition in Belgium]. Med Sci (Paris) 2023; 39:137-144. [PMID: 36799748 DOI: 10.1051/medsci/2023017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
In Belgium, there is not yet a standardized procedure for supporting the transition of patients with chronic diseases from pediatrics to adult health care. However, the field increasingly calls for the development of multidisciplinary landmarks. By crossing perspectives of a pediatrician, two psychologists and an ethicist, we propose the key elements of a successful transition: 1. Start preparing for the transition early; 2. Promote the patient's knowledge, know-how and interpersonal skills; 3. Improve continuity of care and collaboration between patient, family, healthcare teams, patient associations and families; 4. Support parents; 5. Improve the skills of healthcare teams in the specificities of adolescent medicine; 6. Individualize the transition, respecting each person's pace and uniqueness; 7. Develop an interdisciplinary approach of the transition; 8. Develop collaboration with public authorities, national and international experts; 9. Develop research on this emerging field of study.
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Affiliation(s)
- Franck Devaux
- Éthicien, président du comité d'éthique, coordinateur de la fonction maladies rares et maître de conférences, Université libre de Bruxelles (ULB), Hôpital universitaire de Bruxelles (HUB), Hôpital universitaire des enfants Reine Fabiola (HUDERF), Belgique
| | - Christine Fonteyne
- Cheffe de clinique, unité ressource douleur et équipe mobile de soins palliatifs pédiatriques, Université libre de Bruxelles (ULB), Hôpital universitaire de Bruxelles (HUB), Hôpital universitaire des enfants Reine Fabiola (HUDERF), Belgique
| | - Marie Deriez
- Psychologue clinicienne, Université libre de Bruxelles (ULB), Hôpital universitaire de Bruxelles (HUB), Hôpital universitaire des enfants Reine Fabiola (HUDERF), Belgique
| | - Isabelle Lambotte
- Psychologue clinicienne PhD, cheffe du service de psychologie secteur infanto-juvénile, Université libre de Bruxelles (ULB), Hôpital universitaire de Bruxelles (HUB), Hôpital Universitaire des enfants Reine Fabiola (HUDERF), Belgique
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Comment améliorer la transition au sein des CRCM : analyse des besoins des patients et de leurs parents lors de l’arrivée en service adulte. Rev Mal Respir 2022; 39:132-139. [DOI: 10.1016/j.rmr.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 12/22/2021] [Indexed: 11/20/2022]
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Roussel A, Delbet J, Micheland L, Deschênes G, Decramer S, Ulinski T. Quality of life in children with severe forms of idiopathic nephrotic syndrome in stable remission-A cross-sectional study. Acta Paediatr 2019; 108:2267-2273. [PMID: 31240744 DOI: 10.1111/apa.14912] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 11/27/2022]
Abstract
AIM Severe forms of idiopathic nephrotic syndrome (INS) require immunosuppressive therapy: oral treatment or intravenous therapy (rituximab, RTX). The main objective was to describe quality of life (QOL) in these specific patients. METHODS Cross-sectional, multicentre, observational study analysed QOL using a standardised questionnaire in children from 7 to 17 years, with a steroid-dependent or steroid-resistant INS in stable remission. The questionnaire consisted of 30 questions concerning physical and emotional well-being, self-esteem, family, friends, school and disease resulting in a global score of 0-100. RESULTS A total of 110 patients with a mean age of 11.6 years from three French paediatric nephrology centres were included. A total of 71 patients had oral immunosuppressive treatment, 27 had RTX, and 12 had both. 13.6% of patients had a steroid-resistant INS. The mean number of relapses was 5.8. Seventy-eight patients answered the questionnaire. The global score in the whole study population was 74.7; 72.6 in the RTX group, 76.2 in the oral drugs group, (P = 0.49). The results of sub-dimension 'school' were statistically lower in RTX group (61.6 ± 19.5) compared with oral drugs group (71.4 ± 16; P = 0.02). CONCLUSION Global QOL score was high in 'difficult-to-treat' patients with INS in stable remission on oral immunosuppressive or RTX treatment.
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Affiliation(s)
- Aphaia Roussel
- Service de Néphrologie et Dialyse Pédiatrique Hôpital Trousseau, APHP.6, and DHU i2b Paris France
| | - Jean‐Daniel Delbet
- Service de Néphrologie et Dialyse Pédiatrique Hôpital Trousseau, APHP.6, and DHU i2b Paris France
| | | | - Georges Deschênes
- Service de Néphrologie Pédiatrique Hôpital Robert Debré, AP‐HP Paris France
| | | | - Tim Ulinski
- Service de Néphrologie et Dialyse Pédiatrique Hôpital Trousseau, APHP.6, and DHU i2b Paris France
- Sorbonne Université Paris France
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Chabrol B, Jacquin P, Francois L, Broué P, Dobbelaere D, Douillard C, Dubois S, Feillet F, Perrier A, Fouilhoux A, Labarthe F, Lamireau D, Mazodier K, Maillot F, Mochel F, Schiff M, Belmatoug N. Transition from pediatric to adult care in adolescents with hereditary metabolic diseases: Specific guidelines from the French network for rare inherited metabolic diseases (G2M). Arch Pediatr 2018; 25:S0929-693X(18)30115-5. [PMID: 29914755 DOI: 10.1016/j.arcped.2018.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 05/20/2018] [Indexed: 11/15/2022]
Abstract
Inherited metabolic diseases (IMD) form a heterogeneous group of genetic disorders that surface primarily during childhood and result in significant morbidity and mortality. A prevalence of 1 in 2500-5000 live births is often reported. The transfer of adolescents from pediatric care to adult health facilities is often difficult for patients and their families and can lead to a breakdown in medical follow-up and therefore serious complications. Existing recommendations for the successful transition of patients with chronic disorders do not specifically address patients with IMDs associated with dietary treatment. Here, the French network for rare inherited metabolic diseases (G2M) presents its reflections and recommendations for a successful transition. Preparations for the transfer must be made well in advance. The transfer must aim for adolescents gaining autonomy by making them responsible and providing them with the knowledge that will enable them to manage their care themselves, know how to react appropriately if there is any change in their condition, and move comfortably within the adult healthcare system. This requires the active participation of the patient, his or her family, and pediatric and adult care teams. It involves multidisciplinary management plus the production and maintenance of an educational therapy program. Finally, the identification of physicians and dietitians trained in IMDs, relevant subspecialists, and even expert patients could improve the continuum of complete and appropriate care for these patients within adult medicine.
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Affiliation(s)
- B Chabrol
- Hôpital Timone enfants, 264, rue St-Pierre, 13385 Marseille, France.
| | - P Jacquin
- Hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - L Francois
- Hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - P Broué
- Hôpital des Enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex, France
| | - D Dobbelaere
- Hôpital Jeanne-de-Flandres, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59000 Lille, France
| | - C Douillard
- Hôpital Jeanne-de-Flandres, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59000 Lille, France
| | - S Dubois
- Hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75015 Paris, France
| | - F Feillet
- Hopitaux de Brabois, CHU de Nancy, allée du Morvan, 54511 Vandoeuvre-les Nancy, France
| | - A Perrier
- Hôpital femme-mère-enfants, 59, boulevard Pinel, 69677 Bron, France
| | - A Fouilhoux
- Hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - F Labarthe
- Hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - D Lamireau
- CHU Bordeaux-Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - K Mazodier
- Hôpital Timone enfants, 264, rue St-Pierre, 13385 Marseille, France
| | - F Maillot
- Hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - F Mochel
- Hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Schiff
- Hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - N Belmatoug
- Hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France
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Colinart-Thomas M, Noël V, Roques G, Gordes-Grosjean S, Abely M, Pluchart C. [From pediatric care to adult medicine: Transition of sickle cell patients, a French monocentric study]. Arch Pediatr 2018. [PMID: 29530458 DOI: 10.1016/j.arcped.2017.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sickle cell disease, a hemoglobin disorder with autosomal recessive transmission, is one of the most common genetic diseases screened in France. Thanks to early management, 95% of sickle cell patients reach adulthood and require transition from pediatric care to adult care. Through a retrospective study of records from serious sickle cell patients over 17 years old, followed in the hematology-oncology pediatric unit of Reims University Hospital Center in France, we analyzed transition conditions, compared pediatric and adult management, and proposed a plan for transition care. As of 1 January 2016, out of 19 sickle cell patients meeting the inclusion criteria, 12 had made the transition from pediatric care to adult medicine. Among the transition group, the transition was proposed by the pediatrician in 92% of cases. The average age of transition was 19.4 years. The time between receiving the information and the last pediatric visit was 2.4 months. Seven out of the 12 patients were informed of their transition during the last pediatric visit. The age of the first adult visit was 20.3 years. There was no alternate or joint consultation. The treatments prescribed during the last pediatric visit were not modified during the first adult visit. The average number of hospitalizations per patient was 2.7 in pediatric care and 3.4 in adult care with a median value of 2 in both groups. Three out of 12 patients died, the average age of death being 26.7 years. Transition is an important milestone in chronic disease patients. More than age, the maturity of the patient must be taken into account. The transition to the adult structure requires early preparation in the teenage years and investment of the adolescent and his family as well as investment of pediatric and adult caregivers. This study points out the need to establish a transition plan within our hospital in collaboration with adult physicians. Continuity of care is necessary to increase the quality of managing patients and cannot be done without a close relationship between pediatric specialists and adult physicians.
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Affiliation(s)
- M Colinart-Thomas
- Unité d'hémato-oncologie pédiatrique, service de pédiatrie A, hôpital américain, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
| | - V Noël
- Service de médecine interne, maladies infectieuses et immunologie clinique, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - G Roques
- Unité d'hémato-oncologie pédiatrique, service de pédiatrie A, hôpital américain, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - S Gordes-Grosjean
- Unité d'hémato-oncologie pédiatrique, service de pédiatrie A, hôpital américain, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - M Abely
- Unité d'hémato-oncologie pédiatrique, service de pédiatrie A, hôpital américain, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - C Pluchart
- Unité d'hémato-oncologie pédiatrique, service de pédiatrie A, hôpital américain, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
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Potì S, Palareti L, Emiliani F, Rodorigo G, Valdrè L. The subjective experience of living with haemophilia in the transition from early adolescence to young adulthood: the effect of age and the therapeutic regimen. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2017. [DOI: 10.1080/02673843.2017.1299017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Silvia Potì
- Department of Education Studies ‘Giovanni Maria Bertin’, University of Bologna, Bologna, Italy
| | - Laura Palareti
- Department of Education Studies ‘Giovanni Maria Bertin’, University of Bologna, Bologna, Italy
| | - Francesca Emiliani
- Department of Education Studies ‘Giovanni Maria Bertin’, University of Bologna, Bologna, Italy
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Jacquin P. [Living with diabetes during adolescence]. SOINS. PÉDIATRIE, PUÉRICULTURE 2016:33-5. [PMID: 26776693 DOI: 10.1016/j.spp.2015.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Teenagers undergo a period of rapid transformations, on a physical, psychological and social level. Diabetes, at this age, risks undermining these processes due to the constraints of the treatment and the teenagers' increased dependence, notably on their parents. The nursing teams need to be vigilant in helping the teenager and their parents overcome these obstacles, while preserving their future through proper control of the diabetes.
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Affiliation(s)
- Paul Jacquin
- Médecine de l'adolescent, Hôpital Robert-Debré (AP-HP), 48, boulevard Sérurier, 75019 Paris, France.
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Dosso M, Morganella J, Robert Cornide A, Depeyre J, Brun N. P061 Conception d’un programme d’éducation thérapeutique destiné aux adolescents atteints d’hypercholestérolémie familiale. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70393-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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L’adhésion thérapeutique chez l’adolescent atteint de maladie chronique : état de la question. Arch Pediatr 2012; 19:747-54. [DOI: 10.1016/j.arcped.2012.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 02/04/2012] [Accepted: 04/16/2012] [Indexed: 11/20/2022]
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Korb-Savoldelli V, Sabatier B, Gillaizeau F, Guillemain R, Prognon P, Bégué D, Durieux P. Non-adherence with drug treatment after heart or lung transplantation in adults: a systematic review. PATIENT EDUCATION AND COUNSELING 2010; 81:148-54. [PMID: 20627643 DOI: 10.1016/j.pec.2010.04.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 04/06/2010] [Accepted: 04/06/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Heart or lung transplantation is a complex intervention requiring medication adherence. The objective of this systematic review is to estimate the prevalence of non-adherence (NA) with post-transplantation medication in heart or lung recipients and to assess its clinical impact. We examined in the selected studies if the authors considered the patient's perspective in their evaluations. METHODS The electronic database MEDLINE, EMBASE and The Cochrane Central Register were searched. Only studies that reported the number of non-adhere subjects were eligible. The different methods of measurement, the ways in which authors defined NA and if authors had integrated patient's perspective in their secondary objectives were also assessed. RESULTS The range frequency of NA was 1-42.9% for all drugs. Non-adherent patients tend to experience worse outcomes compared to adherent patients. The patient's perception of drug side-effects is the most reported patient-related factor for impairing adherence. CONCLUSION NA after heart or lung transplantation is an important issue and concerns not only immunosuppressant treatments. The main striking point of the selected studies is the lack of patient perspective and the omission of patients-healthcare providers' relationship. PRACTICE IMPLICATIONS Future research must focus on patients' motivation for the medication-taking behaviour.
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Affiliation(s)
- V Korb-Savoldelli
- Pharmacy Department, AP-HP Georges Pompidou European Hospital, Paris, France.
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