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Alheggi A, Alfahhad A, Bukhari A, Bodemer C. Exploring the Impact of Epidermolysis Bullosa on Parents and Caregivers: A Cross-Cultural Validation of the Epidermolysis Bullosa Burden of Disease Questionnaire. Clin Cosmet Investig Dermatol 2024; 17:1027-1032. [PMID: 38737942 PMCID: PMC11086395 DOI: 10.2147/ccid.s459429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
Purpose Epidermolysis bullosa (EB) is a heterogeneous group of genetically inherited skin and mucosal fragility disorders. EB may have a profound impact on parental physical and psychosocial health. This study was designed to evaluate the disease burden in parents of patients with EB and identify out-of-pocket (OOP) expenditures for EB care in Saudi Arabia. Patients and Methods Thirty-eight caregivers of patients with EB were recruited from the Saudi EB registry to participate. All participants completed the EB Burden of Disease (EB-BoD) questionnaire. Data were collected between May 2020 and December 2020. The sample included 10 patients with EB simplex (EBS), 10 with junctional EB (JEB), 14 with dystrophic EB (DEB), and 4 with an unknown type. Results Mothers were the primary caregivers in 89.5% of cases. The mean EB-BoD score was 53 ± 21.5. The family-life and child's life dimensions had the higher burden. The mean EB-BoD score observed in patients with DEB was 62.4±16.8 versus 45.7 ± 19.42 for EBS. The EB-BoD score was correlated with the patient's family income. Most caregivers (97.4%) reported OOP expenditure, with a mean monthly OOP expenditure of $575.5± $701.1. OOP expenses increased with the severity of the condition. Conclusion This study highlights the need for support services for parents caring for patients with EB.
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Affiliation(s)
- Ashjan Alheggi
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Aseel Alfahhad
- Department of Dermatology, College of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abrar Bukhari
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Christine Bodemer
- Department of Dermatology, Expert Centre for Genodermatoses (MAGEC) Necker-Enfants Malades Hospital, University Paris Centre, Paris, France
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Kinariwalla N, Scollan ME, Levin LE, Fernandez Faith E, Lee MT, Powell J, Baselga E, Tollefson MM, Lauren CT, Morel KD, Garzon MC. An investigation of vascular anomalies centers' transition of care practices. Pediatr Dermatol 2023; 40:866-868. [PMID: 37437894 DOI: 10.1111/pde.15391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/24/2023] [Indexed: 07/14/2023]
Abstract
This study aims to examine transition of care (TOC) practices of multidisciplinary vascular anomalies centers (VACs). Thirty-seven of 71 VAC leaders to whom the survey was sent completed the questionnaire. TOC and transfer practices varied with only 16% of VACs having TOC programs. The most frequently cited barriers to developing a TOC program were lack of resources and difficulty finding expert adult providers.
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Affiliation(s)
- Neha Kinariwalla
- Columbia University Irving Medical Center, New York, New York, USA
| | | | - Laura E Levin
- Columbia University Irving Medical Center, New York, New York, USA
| | | | - Margaret T Lee
- Columbia University Irving Medical Center, New York, New York, USA
| | | | | | - Megha M Tollefson
- Mayo Clinic and Mayo Clinic Children's Center, Rochester, Minnesota, USA
| | | | - Kimberly D Morel
- Columbia University Irving Medical Center, New York, New York, USA
| | - Maria C Garzon
- Columbia University Irving Medical Center, New York, New York, USA
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Han J, Dykman M, Lunos S, Nguyen A, Hook KP, Lara-Corrales I, Price HN, Diaz L, Levy M, Boull C. Transition of care in patients with epidermolysis bullosa: A survey study. Pediatr Dermatol 2022; 40:258-260. [PMID: 36573475 DOI: 10.1111/pde.15232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022]
Abstract
There are little published data on the transition of care in EB. We conducted a survey study recruiting EB patients from the Dystrophic EB Research Association (debra) website and centers caring for high numbers of EB patients in the United States and internationally from Sept 17, 2019 to Nov 3, 2021. The majority of participants had not discussed the transition of care with their healthcare providers, nor the healthcare needs to be required as an adult. Ongoing pediatric subspecialty care was reported by 12% of adults, most commonly in pediatric dermatology. Identified barriers to transition included the perceived lack of adult providers' knowledge about EB patient healthcare needs. The results suggest the need for transition guidelines, early discussions with families about transition, and practical information for the adult providers accepting care.
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Affiliation(s)
- Joohee Han
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Morgan Dykman
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott Lunos
- Clinical and Translational Science Institute/Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Audrey Nguyen
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kristen P Hook
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Irene Lara-Corrales
- Dermatology Section, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Harper N Price
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Lucia Diaz
- Division of Dermatology Dell Children's Medical Center, University of Texas Austin Dell Medical School, Austin, Texas, USA
| | - Moise Levy
- Division of Dermatology Dell Children's Medical Center, University of Texas Austin Dell Medical School, Austin, Texas, USA
| | - Christina Boull
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
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Pope EI, Joseph M. Barriers, goals, and enablers of transition of care in pediatric dermatology. Pediatr Dermatol 2022; 40:231-237. [PMID: 36384244 DOI: 10.1111/pde.15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/27/2022] [Indexed: 11/18/2022]
Abstract
Adolescent patients with complex skin disorders may require ongoing care for their conditions as they "age out" of the pediatric setting into adult care. Yet despite consensus from the Canadian Paediatric Society and American Academy of Pediatrics on the importance of dedicated transition programs for these patients, there is a scarcity of such programs worldwide, and no formal programs in Canada. This paper explores several barriers, goals, and potential enablers of transition programs in this discipline and proposes principles of transition versus transfer in the context of pediatric dermatology.
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Affiliation(s)
- Eliza I Pope
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Marissa Joseph
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Vermersch C, Boccara O, Chiaverini C, Mazereeuw-Hautier J, Sigg N, Mallet S, Vabres P, Herbreteau D, Le Touze A, Maruani A, Leducq S. Health care transition for patients with vascular malformations: a French multicenter cross-sectional study. Orphanet J Rare Dis 2021; 16:352. [PMID: 34362421 PMCID: PMC8349005 DOI: 10.1186/s13023-021-01970-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/19/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health care transition (i.e., transition from pediatric to adult care) is challenging in chronic conditions but has been poorly studied in rare chronic skin diseases. We investigated the proportion of lost to follow-up among patients with superficial vascular malformations after health care transition. We also collected patients' opinions. This prospective, multicenter, cross-sectional study was performed at 7 French hospitals. We included patients aged 19-25 years, who were followed for a superficial vascular malformation before age 16, and who had completed the transition period in 2020. Data were collected from medical records and a questionnaire was sent to included patients asking about the health care transition. RESULTS Among the 90 patients included, 41 (46%) were lost to follow-up after health care transition period. The age at diagnosis was significantly higher for lost to follow-up than non- lost to follow-up patients. The lost to follow-up proportion was similar between patients who changed and did not change hospitals during the transition. Responses to the questionnaire were obtained for 47 of 90 patients (52.2% response rate); most were satisfied with their care (n = 31/36, 86.1%); however, a lack of psychological support was reported. CONCLUSIONS Health care transition is associated to a high rate of lost to follow-up. Early management seems associated to less lost to follow-up. Further studies are needed to better understand risk factors for a failed health care transition and its consequences.
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Affiliation(s)
- Camille Vermersch
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de La République, 37044, Tours Cedex 9, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Necker-Enfants Malades University Hospital, APHP5, Paris, France.,Imagine Institute, Paris University, Necker-Enfants Malades University Hospital, APHP5, Paris, France
| | | | | | - Nina Sigg
- Department of Dermatology, University Hospital Center of Angers, Angers, France
| | - Stéphanie Mallet
- Department of Dermatology, University Hospital Center of Marseille, 13885, Marseille Cedex 5, France
| | - Pierre Vabres
- Department of Dermatology, University Hospital Center of Dijon, Dijon, France
| | - Denis Herbreteau
- Department of Neuroradiology and Interventional Radiology, University Hospital Center of Tours, Tours, France
| | - Anne Le Touze
- Department of Pediatric Surgery, University Hospital Center of Tours, Tours, France
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de La République, 37044, Tours Cedex 9, France.,Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000, Tours, France
| | - Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de La République, 37044, Tours Cedex 9, France. .,Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000, Tours, France.
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