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Cassidy M, Doucet S, Luke A, Goudreau A, MacNeill L. Improving the transition from paediatric to adult healthcare: a scoping review on the recommendations of young adults with lived experience. BMJ Open 2022; 12:e051314. [PMID: 36572498 PMCID: PMC9806082 DOI: 10.1136/bmjopen-2021-051314] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/14/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The goal of this review was to identify recommendations within the literature on how to improve the transition from paediatric to adult healthcare from the perspective of young adults (YAs) living with chronic conditions who have gone through the process. DESIGN This review was conducted in accordance with JBI methodology for scoping reviews. SEARCH STRATEGY We searched MEDLINE (Ovid), CINAHL (EBSCO), PsycINFO (EBSCO) and EMBASE (Elsevier) databases, and conducted a grey literature search for relevant material. The databases were searched in December 2019, and re-searched June 2020 and September 2020, while the grey literature was searched in April 2020. This scoping review focused on the recommendations of YAs with chronic conditions who have transitioned from paediatric to adult healthcare, in any setting (eg, hospital, clinic or community), and across all sectors (eg, health, education and social services). RESULTS Eighteen studies met inclusion criteria for this review. These studies included YAs with 14 different chronic conditions, receiving primary health services in North America (67%) and Europe (33%). YAs' recommendations for improving the transition from paediatric to adult healthcare (n=number of studies reported) included: improving continuity of care (n=12); facilitating patient-centred care (n=9); building strong support networks (n=11) and implementing transition education preparedness training (n=7). CONCLUSION Review findings can benefit service delivery by addressing important barriers to health, education, and social services for youth transitioning to adult healthcare.
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Affiliation(s)
- Monique Cassidy
- Centre for Research in Integrated Care, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - Shelley Doucet
- Centre for Research in Integrated Care, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Alison Luke
- Centre for Research in Integrated Care, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Alex Goudreau
- UNB Libraries, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - Lillian MacNeill
- Centre for Research in Integrated Care, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
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Cai RA, Chaplin H, Livermore P, Lee M, Sen D, Wedderburn LR, Wilkinson N, Jeffery R, Kempa A, Norton I, Tattersall R, Ioannou Y, Eleftheriou D. Development of a benchmarking toolkit for adolescent and young adult rheumatology services (BeTAR). Pediatr Rheumatol Online J 2019; 17:23. [PMID: 31113443 PMCID: PMC6528251 DOI: 10.1186/s12969-019-0323-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/26/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Young people (YP; 12-24 years old) with rheumatic diseases face many challenges associated with chronic illness in addition to the physiological and psychosocial changes of adolescence. Timely access to developmentally appropriate multidisciplinary care is key to successfully managing rheumatic diseases, but gaps in the care of this vulnerable age group still exist. This study aimed to develop a benchmarking toolkit to enable comparative evaluation of YP rheumatology services in order to promote best practice and reduce variations in service delivery. METHODS A staged and consultative method was used across a broad group of stakeholders in the UK (YP, parents/other carers, and healthcare professionals, HCPs) to develop this toolkit, with reference to pre-existing standards of YP-friendly healthcare. Eighty-seven YP (median age 19 years, range 12-24 years) and 26 rheumatology HCPs with 1-34 years of experience caring for YP have participated. RESULTS Thirty quality criteria were identified, which were grouped into four main domains: assessment and treatment, information and involvement, accessibility and environment, and continuity of care. Two toolkit versions, one to be completed by HCPs and one to be completed by patients, were developed. These were further refined by relevant groups and face validity was confirmed. CONCLUSIONS A toolkit has been developed to systematically evaluate and benchmark YP rheumatology services, which is key in setting standards of care, identifying targets for improvement and facilitating research. Engagement from YP, clinical teams, and commissioners with this tool should facilitate investigation of variability in levels of care and drive quality improvement.
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Affiliation(s)
- Ran A. Cai
- 0000000121901201grid.83440.3bArthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Hema Chaplin
- 0000 0001 2322 6764grid.13097.3cHealth Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Polly Livermore
- 0000000121901201grid.83440.3bArthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK ,0000 0004 5902 9895grid.424537.3Paediatric Rheumatology Department, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK ,0000000121901201grid.83440.3bUCL GOS Institute of Child Health, University College London, London, UK
| | - Martin Lee
- 0000 0004 0444 2244grid.420004.2Rheumatology Department, Newcastle Upon Tyne Hospitals, Newcastle, UK
| | - Debajit Sen
- 0000000121901201grid.83440.3bArthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK ,0000 0004 0612 2754grid.439749.4Rheumatology, University College London Hospitals, London, UK
| | - Lucy R. Wedderburn
- 0000000121901201grid.83440.3bArthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK ,0000000121901201grid.83440.3bUCL GOS Institute of Child Health, University College London, London, UK ,0000 0001 2116 3923grid.451056.3NIHR Biomedical Research Centre, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Nick Wilkinson
- 0000 0004 5345 7223grid.483570.dPaediatric Rheumatology Department, Evelina London Children’s Hospital, Guys and St Thomas’ NHS Foundation Trust, London, UK
| | - Rachel Jeffery
- grid.500651.7Rheumatology, Northampton General Hospital NHS Trust, Northampton, UK
| | - Andrea Kempa
- grid.500651.7Rheumatology, Northampton General Hospital NHS Trust, Northampton, UK
| | - Imogen Norton
- grid.500651.7Rheumatology, Northampton General Hospital NHS Trust, Northampton, UK
| | - Rachel Tattersall
- 0000 0004 0641 6031grid.416126.6Rheumatology Department, Royal Hallamshire Hospital, Sheffield, UK and Sheffield Children’s Hospital, Sheffield, UK
| | - Yiannis Ioannou
- 0000 0004 0612 2754grid.439749.4Rheumatology, University College London Hospitals, London, UK
| | - Despina Eleftheriou
- 0000000121901201grid.83440.3bArthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK ,0000000121901201grid.83440.3bUCL GOS Institute of Child Health, University College London, London, UK ,0000 0001 2116 3923grid.451056.3NIHR Biomedical Research Centre, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
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