[Adolescents with cystic fibrosis: the approach to transition from paediatric to adult care]

Evaluation of Post-Transfer Clinical Status of Cystic Fibrosis Patients Transferred to Adult Chest Diseases Clinic

INTRODUCTION

Proper transfer of patients from pediatric to adult chest clinic has critical importance. In this study, we aimed to evaluate the follow-up data of the patients in the first 12 months after transfer.

METHODS

Cystic fibrosis (CF) patients previously transferred to adult chest clinics were included. Demographic and clinical data were retrospectively reviewed. The baseline visit was defined as the first visit at the adult center. One-year follow-up data were compared with the baseline data.

RESULTS

A total of 118 patients were included in the study (men/women: 70/48). The mean ages at the time of transfer and inclusion in the study inclusion were 26.5 (23-29) and 27.6 ( ± 6.4) years, respectively. There was a significant reduction in FEV1 (%) and FEV1/FVC ratio between baseline and 1-year follow-up visits (p < 0.001, p < 0.001, respectively). Compared to the year before the transfer, total number of exacerbations (p = 0.001), outpatient clinic visits (p < 0.001), total antibiotic days (p < 0.001), and intravenous antibiotic days (p = 0.001) significantly increased.

CONCLUSIONS

The findings of this study show that the pulmonary functions of CF patients decline and clinical conditions deteriorated after the transfer to the adult clinic. Simple transfer, rather than transition, may be one of the reasons for adverse outcomes in this patient population.

[Transition from pediatric to adult care in chronic respiratory diseases: The cystic fibrosis model]

Increased life expectancy in cystic fibrosis has made transition from pediatric to adult cystic fibrosis centers a crucial step for patients, their families and caregivers. This transition must be gradual and carefully prepared. A formalized process, early discussion with patients and families about transition, patient's empowerment prior to transfer, and close links between pediatric and adult teams are key points to succeed. Therapeutic education, validated questionnaires, personalized action plans or connected tools can help. Transfer will take place at the appropriate time for each patient, ideally during a period of disease stability, in a progressive manner, with joint or alternating consultations between pediatric and adult cystic fibrosis center teams. Other chronic respiratory diseases with pediatric onset may benefit from similar transition processes.

Diagnosis of rare diseases under focus: impacts for Canadian patients

This paper presents an in-depth qualitative analysis of the impact of diagnosis on the lives of rare disease (RD) patients. While diagnosis may be described as a watershed step for RD patients, no extensive account of non-medical outcomes following a RD diagnosis exists within the literature. This study aims to fill this knowledge gap through an analysis of the impact of diagnosis on the lives of RD patients according to their personal experiences. Qualitative research was conducted in three provinces across Canada, with a total of 23 participants, both adult and parents of children with RD, diagnosed and not yet diagnosed. A thematic approach guided the analysis of the transcripts. The results reveal that the impacts of a RD diagnosis for both adults and paediatric patients are multifold, ranging from social to personal and medical impacts (including cases where etiological treatments for the diseases are non-existent). Furthermore, the results shed light on distinct factors that affect the scope of impacts of a diagnosis.