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Pringsheim T, Batla A, Shalash A, Sahu JK, Cosentino C, Ebrahimi‐Fakhari D, Friedman J, Lin J, Mink J, Munchau A, Munoz D, Nardocci N, Perez‐Dueñas B, Sardar Z, Triki C, Ben‐Pazi H, Silveira‐Moriyama L, Troncoso‐Schifferli M, Hoshino K, Dale RC, Fung VS, Kurian MA, Roze E. Transitional Care for Young People with Movement Disorders: Consensus-Based Recommendations from the MDS Task Force on Pediatrics. Mov Disord Clin Pract 2023; 10:748-755. [PMID: 37205244 PMCID: PMC10186998 DOI: 10.1002/mdc3.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/25/2023] [Accepted: 03/05/2023] [Indexed: 05/21/2023] Open
Abstract
Background The International Parkinson and Movement Disorders Society (MDS) set up a working group on pediatric movement disorders (MDS Task Force on Pediatrics) to generate recommendations to guide the transition process from pediatrics to adult health care systems in patients with childhood-onset movement disorders. Methods To develop recommendations for transitional care for childhood onset movement disorders, we used a formal consensus development process, using a multi-round, web-based Delphi survey. The Delphi survey was based on the results of the scoping review of the literature and the results of a survey of MDS members on transition practices. Through iterative discussions, we generated the recommendations included in the survey. The MDS Task Force on Pediatrics were the voting members for the Delphi survey. The task force members comprise 23 child and adult neurologists with expertise in the field of movement disorders and from all regions of the world. Results Fifteen recommendations divided across four different areas were made pertaining to: (1) team composition and structure, (2) planning and readiness, (3) goals of care, and (4) administration and research. All recommendations achieved consensus with a median score of 7 or greater. Conclusion Recommendations on providing transitional care for patients with childhood onset movement disorders are provided. Nevertheless several challenges remain in the implementation of these recommendations, related to health infrastructure and the distribution of health resources, and the availability of knowledgeable and interested practitioners. Research on the influence of transitional care programs on outcomes in childhood onset movement disorders is much needed.
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Affiliation(s)
- Tamara Pringsheim
- Department of Clinical NeurosciencesPsychiatry, Pediatrics and Community Health Sciences, University of CalgaryCalgaryABCanada
| | - Amit Batla
- Department of Clinical and Movement NeuroscienceUCL Queen Square Institute of NeurologyLondonUK
| | - Ali Shalash
- Department of NeurologyFaculty of medicine, Ain Shams UniveristyCairoEgypt
| | - Jitendra Kumar Sahu
- Pediatric Neurology Unit, Postgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Carlos Cosentino
- Department of Neurodegenerative DiseasesInstituto Nacional de Ciencias Neurologicas and School of Medicine, Universidad Nacional Mayor de San MarcosLimaPeru
| | | | - Jennifer Friedman
- Departments of Neurosciences and PediatricsUC San DiegoSan DiegoCAUSA
| | - Jean‐Pierre Lin
- Children's Neurosciences, Complex Motor Disorders Service (CMDS)Evelina London Children's Hospital, Guy's and St Thomas’ NHS Foundation Trust (GSTT), and Women and Children's Health Institute Faculty of Life Sciences & Medicine, Kings Health Partners, King's College LondonLondonUK
| | - Jonathan Mink
- Department of NeurologyUniversity of RochesterRochesterNYUSA
| | - Alexander Munchau
- Institute of Systems Motor Science, University of LübeckLübeckGermany
| | - Daniela Munoz
- Department of Paediatric NeurologySan Borja Arriaran Hospital. University of ChileSantiagoChile
| | - Nardo Nardocci
- Pediatric Neuroscience DepartmentFondazione IRCCS Istituto Neurologico “C Besta”MilanItaly
| | - Belen Perez‐Dueñas
- Department of Pediatric NeurologyHospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona. Centre for Biomedical Research of Rare Diseases (CIBERER), ISCIIIMadridSpain
| | - Zomer Sardar
- FCPS, Department of NeurologyColumbia University Irving Medical Center/New York Presbyterian HospitalNew YorkNYUSA
| | - Chahnez Triki
- Department of child neurologyHedi Chaker Hospital, LR10ES15, Sfax Medical School, University of Sfax TunisiaSfaxTunisia
| | | | | | | | - Kyoko Hoshino
- Segawa Memorial Neurological Clinic for ChildrenTokyoJapan
| | - Russell C. Dale
- Children's Hospital at Westmead Clinical School, University of SydneySydneyNSWAustralia
| | - Victor S.C. Fung
- Movement Disorders Unit, Department of NeurologyWestmead Hospital & Sydney Medical School, University of SydneySydneyNSWAustralia
| | - Manju A. Kurian
- Developmental NeurosciencesZayed Centre for Research into Rare Disease in Children, GOS‐Institute of Child Health, UCLLondonUK
| | - Emmanuel Roze
- Sorbonne UniversityParis Brain Institute, Assistance Publique—Hôpitaux de Paris, DMU NeurosciencesParisFrance
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Girela-Serrano B, Miguélez C, Porras-Segovia AA, Díaz C, Moreno M, Peñuelas-Calvo I, Roselló R, Baca-García E, Carballo JJ. Predictors of mental health service utilization as adolescents with attention deficit hyperactivity disorder transition into adulthood. Early Interv Psychiatry 2023; 17:252-262. [PMID: 35706409 DOI: 10.1111/eip.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/01/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) symptoms may persist into adulthood and are likely to cause great problems in young adults. To date, few studies have explored the characteristics of patients diagnosed with ADHD that might influence the utilization of adult mental health services (AMHS). We aimed to examine and identify predictive symptoms of AMHS. METHODS We analysed data from 114 participants diagnosed with ADHD from a cohort of adolescents recruited at the age of 12-17 years, who, at the time of data analysis, were over 18 years old. RESULTS Among AMHS users, hyperactivity/impulsivity measures were significantly more severe (t = 2.668, df = 112, p < .001), ADHD combined subtype diagnosis (χ2 = 4.66, df = 1, p = .031) was more frequent and dysregulation profile in the SDQ-P was also significantly higher (t = -2.497, df = 109, p = .014). However, the dysregulation profile did not remain statistically significant after controlling for type of AMHS contact. CONCLUSIONS Our findings suggest that adolescents with ADHD are more likely continue their care under AMHS if they present more severe symptoms of hyperactivity/impulsivity and emotional dysregulation. The better characterization of the patient profile will help clinicians to early identify groups at-risk and to tailor interventions and prevention strategies.
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Affiliation(s)
- Braulio Girela-Serrano
- Westminster Child & Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, UK
- Division of Psychiatry, Imperial College, London, UK
| | - Carolina Miguélez
- Department of Child and Adolescent Psychiatry, Hospital Niño Jesús, Madrid, Spain
| | - Alejandro Albán Porras-Segovia
- Division of Psychiatry, Imperial College, London, UK
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | | | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | | | - Rocio Roselló
- Division of Psychiatry, Imperial College, London, UK
- Department of Psychiatry, University Hospital Doctor Peset of Valencia & University of Valencia, Valencia, Spain
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Universidad Católica del Maule, Talca, Chile
- Université de Nîmes, Nîmes, France
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Scarpellini F, Bonati M. Transition care for adolescents and young adults with attention-deficit hyperactivity disorder (ADHD): A descriptive summary of qualitative evidence. Child Care Health Dev 2022; 49:431-443. [PMID: 36223008 DOI: 10.1111/cch.13070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 09/07/2022] [Accepted: 10/08/2022] [Indexed: 11/28/2022]
Abstract
The review presents a summary of available evidence about transition care of ADHD patients from all service users' perspectives. Common barriers, and suggestions for improvement ADHD of transition care, were extrapolated from qualitative research, including case notes studies, and were exposed. A comprehensive search of the PubMed, Embase, PsychInfo and Web of Science databases for articles published up to October 2021 was conducted to summarize recent evidence on the experiences of all stakeholders involved in the transition process. Reviews, other chronic conditions and different meaning of transition were excluded. Authors extracted data and assessed study quality independently. Findings were discussed taking into consideration barriers and suggestions from all service users' perspectives. Findings from 23 studies with different context and methods were collected and summarized. Most of the studies were conducted in UK, using interviews and questionnaires, and addressed to the physicians. The lack of information about ADHD as a condition and about transition process were the barriers most reported, while joint working and sharing transition protocols were the suggestions pointed out by all stakeholders. Despite different perspectives, all stakeholders exposed similar needs. The review reveals an evident need for defining and evaluating the effectiveness of transition programmes from child to adult ADHD services.
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Affiliation(s)
- Francesca Scarpellini
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Bonati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Quintero J, Rodríguez-Quiroga A, Álvarez-Mon MÁ, Mora F, Rostain AL. Addressing the Treatment and Service Needs of Young Adults with Attention Deficit Hyperactivity Disorder. Child Adolesc Psychiatr Clin N Am 2022; 31:531-551. [PMID: 35697400 DOI: 10.1016/j.chc.2022.03.007] [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] [Indexed: 11/25/2022]
Abstract
The transition from adolescence to adulthood is a complex period in which multiple changes take place (education, work, independent living, and social relations). This stage is especially difficult for adolescents suffering from attention deficit hyperactivity disorder (ADHD), who have to move on from child and adolescent mental health services to adult mental health services. This review analyzes developmental and environmental risk and protective factors as well as critical variables such as executive functioning and self-monitoring that influence the course of ADHD in transitional age youth and guide the priorities for an optimal transition of care. The influence of the COVID-19 pandemic is also discussed. We reflect on the unmet needs for an optimal transition of care and propose practice and policy recommendations to achieve this goal.
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Affiliation(s)
- Javier Quintero
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Legal Medicine & Psychiatry, Complutense University, Spain.
| | - Alberto Rodríguez-Quiroga
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Legal Medicine & Psychiatry, Complutense University, Spain
| | - Miguel Ángel Álvarez-Mon
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28801 Alcala de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Fernando Mora
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Legal Medicine & Psychiatry, Complutense University, Spain
| | - Anthony L Rostain
- Department of Psychiatry, Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, USA
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Ballmann C, Kölle MA, Bekavac-Günther I, Wolf F, Pargent F, Barzel A, Philipsen A, Gensichen J. Evaluation of the German Version of the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 as a Screening Tool for Adult Attention-Deficit/Hyperactivity Disorder in Primary Care. Front Psychol 2022; 13:858147. [PMID: 35529560 PMCID: PMC9075696 DOI: 10.3389/fpsyg.2022.858147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Adult attention-deficit/hyperactivity disorder (ADHD) is common, but often undiagnosed. A valid and time-efficient screening tool for primary care is needed. Objective of this study is to evaluate the German version of the Adult ADHD Self-Report Scale for DSM-5 (ASRS-5) and its feasibility, acceptability, and reliability as a screening tool for adult ADHD in primary care. A multi-centered prospective, diagnostic study was performed. We recruited 262 patients in primary care practices and at an ADHD Outpatient Service of a department of psychiatry in Germany. Patients from 18 to 65 years with suspected or diagnosed ADHD were included by medical doctors, as well as non-ADHD patients as "negative controls." Participants filled in the ASRS-5 and a sociodemographic questionnaire. The Integrated Diagnosis of Adult ADHD, revised version (IDA-R) performed by trained interviewers was used for validation. Feasibility, acceptability, and credibility in primary care practices were examined through a semi-structured interview. The German version of the ASRS-5 showed comparable psychometric properties to the English original version (sensitivity 95.6% and specificity 72.3%). For factor structure, a parallel analysis suggested one latent dimension. Performing confirmatory factor analysis, the best fit was achieved for a general factor with one correlated error. Internal consistency results in Raykovs Omega = 0.86 and Cronbach's α = 0.88. The ASRS-5 was assessed positively in terms of feasibility, acceptability, and credibility by interviewed general practitioners. Potential problems were raised for "treatment options," "stigmatization," and "knowledge gaps." In conclusion, the German version of the ASRS-5 offers a promising tool to improve adult ADHD patients' diagnosis and healthcare.
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Affiliation(s)
- Cora Ballmann
- Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | | | | | - Florian Wolf
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | | | - Anne Barzel
- Institute of General Medicine, Ulm University, Ulm, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians-University, Munich, Germany
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Kappi A, Martel M. Parental Barriers in Seeking Mental Health Services for Attention Deficit Hyperactivity Disorder in Children: Systematic Review. J Atten Disord 2022; 26:408-425. [PMID: 33472504 DOI: 10.1177/1087054720986909] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Many children at risk for negative outcomes related to untreated attention deficit hyperactivity disorder (ADHD) do not receive necessary mental healthcare. Parents' mental health-seeking behavior is important in the early identification of ADHD and preventing comorbidities with ADHD. Parents may experience some barriers that may delay or stop parents from seeking mental healthcare for their children. METHOD This systematic review summarized existing evidence of parents' barriers to seeking mental healthcare for their children at risk of ADHD. RESULTS This review included 21 studies that address different parental barriers under the three levels of the social-ecological model, including individual, interpersonal, and community levels. CONCLUSION Raising parents' awareness of the process of seeking mental healthcare has the potential to help identify children at risk for ADHD earlier. Developing psychoeducational intervention that improves parents' seeking behavior and reduces barriers toward seeking mental healthcare is needed.
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Simpson J, Robinson T, Vale L. Exploration of the costs of accessing health services: data from a longitudinal study of young people in transition from paediatric to adult services. BMC Health Serv Res 2021; 21:263. [PMID: 33743694 PMCID: PMC7981799 DOI: 10.1186/s12913-021-06280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Economic evaluations that include the patient perspective often base their estimates of patient time and travel costs on data collected at a single point in time. This, however, may be inaccurate if the costs of accessing care change substantially over time, as may be the case for young people in transition from paediatric to adult health services. AIMS The aim of this study was to explore the differences in these time and travel costs between two data collection points for young individuals in transition between health care services, and thus to provide an insight of whether such costs should be collected more than once. METHODS Descriptive statistics and regression modelling were used to estimate the average difference in costs between the two points of data collection, as well as the potential drivers of those cost differences. RESULTS We found a small difference in costs between the two time points, equal to -£45.78 [95% CI: - 89.70 to - 1.86]. The results were largely driven by changes in the unit cost of visits and in the number of attendances. CONCLUSIONS A simple and common assumption that patient costs could be collected at a single time point cannot be made in the context of our study. When deciding on the frequency of elicitation of patient costs, future studies should consider the relative impacts of additional data collection on the estimates of efficiency, inequalities and resource implications for collecting new data.
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Affiliation(s)
- Julija Simpson
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tomos Robinson
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Disruption of Pharmacotherapy During the Transition from Adolescence to Early Adulthood in Patients with Attention-Deficit/Hyperactivity Disorder: A Claims Database Analysis Across the USA. CNS Drugs 2021; 35:575-589. [PMID: 33856656 PMCID: PMC8144091 DOI: 10.1007/s40263-021-00808-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) treatment rates in adults are low, possibly owing to discontinuation of pediatric care due to various circumstances (including inadequate health insurance coverage, poor disease insight, and patient/family resistance, as well as those who manage their ADHD independent of pharmacologic intervention) during the transition from adolescence to adulthood. To improve the understanding of treatment patterns during this transition, this study characterized pharmacotherapy use in patients with ADHD aged 16-21 years. METHODS A retrospective claims analysis of the IBM® MarketScan® Commercial Databases, which represent all census regions of the USA, included patients aged 16-21 years with two or more ADHD diagnoses between 1/1/2008 and 12/31/2017 (one or more diagnoses during the year of age 17) who were continuously enrolled from ages 16-21 years and prescribed ADHD medication for ≥ 6 months at age 17 years. Pharmacotherapy use was assessed longitudinally. Comparisons between ages were conducted using Wilcoxon signed-rank tests and McNemar tests. Treatment discontinuation was estimated using Kaplan-Meier analyses. RESULTS The analysis included 10,292 patients. The overall percentage of patients receiving pharmacotherapy significantly decreased (p < 0.001, regardless of treatment type and presence of co-occurring psychiatric disorders) as patients aged, with a median time to treatment discontinuation of 2.94 years. Among patients using pharmacotherapy at the age of 17 years, more than 30% were no longer using pharmacotherapy at age 21 years. As patients aged, the percentage using long-acting amphetamines or methylphenidates decreased, and the percentage receiving no treatment increased. The percentage of patients with disrupted treatment from age 18 to 21 years ranged from 17.9 to 24.1%. After transitioning to disrupted treatment or no treatment, low percentages of patients returned to pharmacotherapy use (disrupted treatment: 15.7-21.5% per year; no treatment, 2.7-3.8% per year). Across all age groups, statistically significantly greater (p < 0.05) percentages of patients with co-occurring psychiatric disorders used lisdexamfetamine, dextroamphetamine-amphetamine mix short acting, and non-stimulants compared with patients without co-occurring psychiatric disorders. Patients with co-occurring psychiatric disorders remained on ADHD pharmacotherapy longer and switched or augmented their pharmacotherapy more frequently than patients without co-occurring psychiatric comorbidities. CONCLUSIONS Patients rarely reinitiated treatment after pharmacotherapy was disrupted or discontinued, emphasizing the need for increased focus on the management of ADHD as patients transition from adolescence to adulthood.
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McGovern E, Pringsheim T, Medina A, Cosentino C, Shalash A, Sardar Z, Fung VSC, Kurian MA, Roze E. Transitional Care for Young People with Neurological Disorders: A Scoping Review with A Focus on Patients with Movement Disorders. Mov Disord 2020; 36:1316-1324. [PMID: 33200525 DOI: 10.1002/mds.28381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood-onset movement disorders represent a heterogenous group of conditions. Given the complexity of these disorders, the transition of care from pediatric to adult medicine is an important consideration. We performed a scoping review of the literature on transitional care in chronic neurological disease, exploring key transitional issues and proposed transitional care models. Our aim was to describe the current knowledge and gaps about the transition process of young adults with chronic neurological disorders, paying special attention to childhood onset movement disorders. A total of 64 articles were included in the qualitative synthesis; 56 articles reported on transitional care issues, and 8 articles reported on transitional care models. Only 2 articles included patients with movement disorders. The following 4 main transitional issues were identified following synthesis of the available literature: (1) inadequate preparation for the transition process, (2) inappropriate and inconsistent transition practices, (3) inadequate adult services, and (4) heightened emotional response surrounding transition. Of the reported transitional care models, multidisciplinary ambulatory care was the most common approach. In studies evaluating patient-related outcomes, positive health, educational, and vocational outcomes were found. The available literature provides insights on issues that can arise during transition that should be addressed to improve patient and caregiver comfort and satisfaction with care. Further research is needed to evaluate how transitional care programs affect outcomes and their cost effectiveness. More studies are required to determine the needs and outcomes specific to patients with childhood onset movement disorders. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Eavan McGovern
- Dublin Neurological Institute, Mater University Hospital, Dublin, Ireland
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Alex Medina
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Zomer Sardar
- Department of Neurology, Mayo Hospital, Lahore, Pakistan
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital & Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Emmanuel Roze
- Department of Neurology, Salpêtrière Hospital, Sorbonne University and Assistance Publique - Hôpitaux de Paris, Paris, France
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Vuori M, Koski-Pirilä A, Martikainen JE, Saastamoinen L. Gender- and age-stratified analyses of ADHD medication use in children and adolescents in Finland using population-based longitudinal data, 2008-2018. Scand J Public Health 2020; 48:303-307. [PMID: 31985349 PMCID: PMC7346711 DOI: 10.1177/1403494820901426] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: This study examined medication use for attention-deficit/hyperactivity disorder (ADHD) among children and adolescents by gender in Finland during 2008-2018. Methods: Aggregated data on medication use for ADHD from 2008 to 2018 were extracted from the nationwide register on reimbursed prescriptions. The annual prevalence of ADHD medication use was calculated as the number of children (6-12 years) and adolescents (13-17 years) per calendar year with at least one ADHD medication purchase divided by the number of children and adolescents in the population. Population prevalence for children was also examined by birth month. Results: In 2008, the prevalence rates for males were 1.26% in children and 0.93% in adolescents, and for females 0.21% and 0.14%, respectively. In 2018, the prevalence rates for males were 4.42% in children and 4.21% in adolescents, and for females 0.99% and 1.28%, respectively. Male-to-female ratios decreased during the study period from 6.0:1 to 4.5:1 (children) and from 6.6:1 to 3.3:1 (adolescents). ADHD medication use was more common among males and females (aged 6-12 years) born in May-August or September-December than among males and females born in January-April. Conclusions: The prevalence of ADHD medication use has continued to increase in Finland. Although use has increased more rapidly among females resulting in lower male-to-female ratios, medication use among females is considerably lower compared with males. Consequently, gender discrepancy in 2018 was relatively large, particularly among children. Future studies should also consider reporting annual prevalence by children's birth month.
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Affiliation(s)
- Miika Vuori
- Department of Teacher Education, Turku Institute for Advanced Studies, University of Turku, Finland
| | - Anna Koski-Pirilä
- Analytics Unit, Social Insurance Institution of Finland, Helsinki, Finland (Kela)
| | - Jaana E Martikainen
- Research Unit, Social Insurance Institution of Finland, Helsinki, Finland (Kela)
| | - Leena Saastamoinen
- Research Unit, Social Insurance Institution of Finland, Helsinki, Finland (Kela)
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Price A, Ford T, Janssens A, Williams AJ, Newlove-Delgado T. Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder. BJPsych Open 2020; 6:e7. [PMID: 31902389 PMCID: PMC7001474 DOI: 10.1192/bjo.2019.94] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/01/2019] [Accepted: 11/26/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Approximately 20% of children with attention-deficit hyperactivity disorder (ADHD) experience clinical levels of impairment into adulthood. In the UK, there is a sharp reduction in ADHD drug prescribing over the period of transition from child to adult services, which is higher than expected given estimates of ADHD persistence, and may be linked to difficulties in accessing adult services. Little is currently known about geographical variations in prescribing and how this may relate to service access. AIMS To analyse geographic variations in primary care prescribing of ADHD medications over the transition period (age 16-19 years) and adult mental health service (AMHS) referrals, and illustrate their relationship with UK adult ADHD service locations. METHOD Using a Clinical Practice Research Datalink cohort of people with an ADHD diagnosis aged 10-20 in 2005 (study period 2005-2013; n = 9390, 99% diagnosed <18 years), regional data on ADHD prescribing over the transition period and AMHS referrals, were mapped against adult ADHD services identified in a linked mapping study. RESULTS Differences were found by region in the mean age at cessation of ADHD prescribing, range 15.8-17.4 years (P<0.001), as well as in referral rates to AMHSs, range 4-21% (P<0.001). There was no obvious relationship between service provision and prescribing variation. CONCLUSIONS Clear regional differences were found in primary care prescribing over the transition period and in referrals to AMHSs. Taken together with service mapping, this suggests inequitable provision and is important information for those who commission and deliver services for adults with ADHD.
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Affiliation(s)
- Anna Price
- Research Fellow, College of Medicine and Health, University of Exeter, UK
| | - Tamsin Ford
- Professor of Child and Adolescent Psychiatry, University of Cambridge, UK
| | - Astrid Janssens
- Associate Professor, Department of Public Health, University of Southern Denmark, Denmark; and Honorary Associate Professor, University of Exeter Medical School, UK
| | - Andrew James Williams
- Lecturer, European Centre for Environment and Human Health, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, UK
| | - Tamsin Newlove-Delgado
- Senior Clinical Lecturer and Honorary Consultant in Public Health, College of Medicine and Health, University of Exeter, UK
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Jonsson U, Coco C, Fridell A, Brown S, Berggren S, Hirvikoski T, Bölte S. Proof of concept: The TRANSITION program for young adults with autism spectrum disorder and/or attention deficit hyperactivity disorder. Scand J Occup Ther 2019; 28:78-90. [PMID: 31790309 DOI: 10.1080/11038128.2019.1695933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The support needs of people with neurodevelopmental disorders are not sufficiently met during the initial years of adulthood. AIM To evaluate feasibility and preliminary effects of a novel programme designed to empower young adults with autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD) to make progress within significant life domains (i.e. work, education, finance, housing/household management, health, leisure/participation in society, and relationships/social network). MATERIAL AND METHOD TRANSITION is a 24-week programme that combines group-based workshops with personalised support based on goal attainment scaling. The study enrolled 26 young adults (50% females; age 17-24 years) in the normative intellectual range, diagnosed with ASD (n = 8), ADHD (n = 4), or both (n = 14). The intervention was delivered by the regular staff of publicly funded psychiatric services in Stockholm, Sweden. RESULTS The programme was possible to implement with minor deviations from the manual. Participants and staff generally viewed the intervention positively, but also provided feedback to guide further improvement. There was a high degree of attendance throughout, with 21 participants (81%) completing the programme. All completers exceeded their predefined goal expectations within at least one domain. CONCLUSIONS The TRANSITION-programme is a promising concept that deserves further evaluation.
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Affiliation(s)
- Ulf Jonsson
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Christina Coco
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Anna Fridell
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Sara Brown
- The Swedish Prison and Probation Service, Norrköping, Sweden
| | - Steve Berggren
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Tatja Hirvikoski
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Habilitation and Health, Stockholm County Council, Stockholm, Sweden
| | - Sven Bölte
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden.,Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia
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13
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Wolraich ML, Chan E, Froehlich T, Lynch RL, Bax A, Redwine ST, Ihyembe D, Hagan JF. ADHD Diagnosis and Treatment Guidelines: A Historical Perspective. Pediatrics 2019; 144:peds.2019-1682. [PMID: 31570649 DOI: 10.1542/peds.2019-1682] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2019] [Indexed: 11/24/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral condition and the second most common chronic illness in children. The observance of specific behaviors in multiple settings have remained the most successful method for diagnosing the condition, and although there are differences in specific areas of the brain, and a high heritability estimate (∼76%), they are not diagnostically specific. Medications, and particularly stimulant medication, have undergone rigorous studies to document their efficacy dating back to the 1970s. Likewise, behavioral interventions in the form of parent training and classroom programs have demonstrated robust efficacy during the same time period. Both medication and behavioral interventions are symptomatic treatments. The availability of only symptomatic treatments places ADHD in the same category as other chronic conditions such as diabetes and asthma. Successful treatment of most individuals requires ongoing adherence to the therapy. Improved communication between patients and their families, primary and mental health providers, and school personnel is necessary for effective ADHD treatment. Further enhancement of electronic systems to facilitate family, school, and provider communication can improve monitoring of ADHD symptoms and functional performance. The American Academy of Pediatrics ADHD guidelines were initially developed to help primary care clinicians address the needs of their patients with ADHD and were further refined with the second revision in 2019.
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Affiliation(s)
- Mark L Wolraich
- University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, Oklahoma;
| | - Eugenia Chan
- Boston Children's Hospital, Boston, Massachusetts
| | - Tanya Froehlich
- Department of Pediatrics, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Ami Bax
- University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, Oklahoma
| | - Susan T Redwine
- University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, Oklahoma
| | - Demvihin Ihyembe
- University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, Oklahoma
| | - Joseph F Hagan
- University of Vermont Children's Hospital, Burlington, Vermont
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14
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Colver A, Rapley T, Parr JR, McConachie H, Dovey-Pearce G, Couteur AL, McDonagh JE, Bennett C, Hislop J, Maniatopoulos G, Mann KD, Merrick H, Pearce MS, Reape D, Vale L. Facilitating the transition of young people with long-term conditions through health services from childhood to adulthood: the Transition research programme. PROGRAMME GRANTS FOR APPLIED RESEARCH 2019. [DOI: 10.3310/pgfar07040] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background
As young people with long-term conditions move from childhood to adulthood, their health may deteriorate and their social participation may reduce. ‘Transition’ is the ‘process’ that addresses the medical, psychosocial and educational needs of young people during this time. ‘Transfer’ is the ‘event’ when medical care moves from children’s to adults’ services. In a typical NHS Trust serving a population of 270,000, approximately 100 young people with long-term conditions requiring secondary care reach the age of 16 years each year. As transition extends over about 7 years, the number in transition at any time is approximately 700.
Objectives
Purpose – to promote the health and well-being of young people with long-term conditions by generating evidence to enable NHS commissioners and providers to facilitate successful health-care transition. Objectives – (1) to work with young people to determine what is important in their transitional health care, (2) to identify the effective and efficient features of transitional health care and (3) to determine how transitional health care should be commissioned and provided.
Design, settings and participants
Three work packages addressed each objective. Objective 1. (i) A young people’s advisory group met monthly throughout the programme. (ii) It explored the usefulness of patient-held health information. (iii) A ‘Q-sort’ study examined how young people approached transitional health care. Objective 2. (i) We followed, for 3 years, 374 young people with type 1 diabetes mellitus (150 from five sites in England), autism spectrum disorder (118 from four sites in England) or cerebral palsy (106 from 18 sites in England and Northern Ireland). We assessed whether or not nine proposed beneficial features (PBFs) of transitional health care predicted better outcomes. (ii) We interviewed a subset of 13 young people about their transition. (iii) We undertook a discrete choice experiment and examined the efficiency of illustrative models of transition. Objective 3. (i) We interviewed staff and observed meetings in three trusts to identify the facilitators of and barriers to introducing developmentally appropriate health care (DAH). We developed a toolkit to assist the introduction of DAH. (ii) We undertook a literature review, interviews and site visits to identify the facilitators of and barriers to commissioning transitional health care. (iii) We synthesised learning on ‘what’ and ‘how’ to commission, drawing on meetings with commissioners.
Main outcome measures
Participation in life situations, mental well-being, satisfaction with services and condition-specific outcomes.
Strengths
This was a longitudinal study with a large sample; the conditions chosen were representative; non-participation and attrition appeared unlikely to introduce bias; the research on commissioning was novel; and a young person’s group was involved.
Limitations
There is uncertainty about whether or not the regions and trusts in the longitudinal study were representative; however, we recruited from 27 trusts widely spread over England and Northern Ireland, which varied greatly in the number and variety of the PBFs they offered. The quality of delivery of each PBF was not assessed. Owing to the nature of the data, only exploratory rather than strict economic modelling was undertaken.
Results and conclusions
(1) Commissioners and providers regarded transition as the responsibility of children’s services. This is inappropriate, given that transition extends to approximately the age of 24 years. Our findings indicate an important role for commissioners of adults’ services to commission transitional health care, in addition to commissioners of children’s services with whom responsibility for transitional health care currently lies. (2) DAH is a crucial aspect of transitional health care. Our findings indicate the importance of health services being commissioned to ensure that providers deliver DAH across all health-care services, and that this will be facilitated by commitment from senior provider and commissioner leaders. (3) Good practice led by enthusiasts rarely generalised to other specialties or to adults’ services. This indicates the importance of NHS Trusts adopting a trust-wide approach to implementation of transitional health care. (4) Adults’ and children’s services were often not joined up. This indicates the importance of adults’ clinicians, children’s clinicians and general practitioners planning transition procedures together. (5) Young people adopted one of four broad interaction styles during transition: ‘laid back’, ‘anxious’, ‘wanting autonomy’ or ‘socially oriented’. Identifying a young person’s style would help personalise communication with them. (6) Three PBFs of transitional health care were significantly associated with better outcomes: ‘parental involvement, suiting parent and young person’, ‘promotion of a young person’s confidence in managing their health’ and ‘meeting the adult team before transfer’. (7) Maximal service uptake would be achieved by services encouraging appropriate parental involvement with young people to make decisions about their care. A service involving ‘appropriate parental involvement’ and ‘promotion of confidence in managing one’s health’ may offer good value for money.
Future work
How might the programme’s findings be implemented by commissioners and health-care providers? What are the most effective ways for primary health care to assist transition and support young people after transfer?
Study registration
This study is registered as UKCRN 12201, UKCRN 12980, UKCRN 12731 and UKCRN 15160.
Funding
The National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Allan Colver
- Child Health Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Tim Rapley
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Complex Neurodevelopmental Disorders Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Gail Dovey-Pearce
- Child Health Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ann Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Complex Neurodevelopmental Disorders Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Janet E McDonagh
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Jennifer Hislop
- Health Economics Group, Newcastle University, Newcastle upon Tyne, UK
| | | | - Kay D Mann
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Hannah Merrick
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Mark S Pearce
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Debbie Reape
- Child Health Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Luke Vale
- Health Economics Group, Newcastle University, Newcastle upon Tyne, UK
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15
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Solanke F, Colver A, McConachie H. Are the health needs of young people with cerebral palsy met during transition from child to adult health care? Child Care Health Dev 2018; 44:355-363. [PMID: 29377236 PMCID: PMC5900977 DOI: 10.1111/cch.12549] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/22/2017] [Accepted: 12/30/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND The transition from child to adult health care is a particular challenge for young people with cerebral palsy, who have a range of needs. The measurement of reported needs, and in particular unmet needs, is one means to assess the effectiveness of services. METHODS We recruited 106 young people with cerebral palsy, before transfer from child services, along with their parents to a 3-year longitudinal study. Reported needs were measured with an 11-item questionnaire covering speech, mobility, positioning, equipment, pain, epilepsy, weight, control of movement, bone or joint problems, curvature of the back, and eyesight. Categorical principal component analysis was used to create factor scores for bivariate and regression analyses. RESULTS A high level of reported needs was identified particularly for control of movement, mobility, and equipment, but these areas were generally being addressed by services. The highest areas of unmet needs were for management of pain, bone or joint problems, and speech. Analysis of unmet needs yielded two factor scores, daily living health care and medical care. Unmet needs in daily living health care were related to severity of motor impairment and to attending nonspecialist education. Unmet needs tended to increase over time but were not significantly (p > .05) related to whether the young person had transferred from child services. CONCLUSIONS Reporting of unmet needs can indicate where service development is required, and we have shown that the approach to measurement can be improved. As the number of unmet health needs at the start of transition is considerable, unmet health needs after transition cannot all be attributed to poor transitional health care. The range and continuation of needs of young people with cerebral palsy argue for close liaison between adult services and child services and creation of models of practice to improve coordination.
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Affiliation(s)
- F. Solanke
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - A. Colver
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - H. McConachie
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
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16
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Law EF, Groenewald CB, Zhou C, Palermo TM. Effect on Health Care Costs for Adolescents Receiving Adjunctive Internet-Delivered Cognitive-Behavioral Therapy: Results of a Randomized Controlled Trial. THE JOURNAL OF PAIN 2018; 19:910-919. [PMID: 29578090 DOI: 10.1016/j.jpain.2018.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/12/2018] [Accepted: 03/07/2018] [Indexed: 12/17/2022]
Abstract
The economic burden of pediatric chronic pain is high, with an estimated annual cost of $19.5 billion. Little is known about whether psychological treatment for pediatric chronic pain can alter health care utilization for youth. The primary aim of this secondary data analysis was to evaluate the effect of adjunctive internet cognitive-behavioral therapy intervention or adjunctive internet education on health care-related economic costs in a cohort of adolescents with chronic pain recruited from interdisciplinary pain clinics across the United States. For the full sample, health care expenditures significantly decreased from the year before the intervention to the year after the intervention. Results indicated that the rate of change in health care costs over time was not significantly different between the internet cognitive-behavioral therapy intervention and adjunctive internet education groups. Further research is needed to replicate these findings and determine patterns and drivers of health care costs for youth with chronic pain evaluated in interdisciplinary pain clinics and whether psychological treatments can alter these patterns. This trial was registered at clinicaltrials.gov (identifier NCT01316471). PERSPECTIVE Health care expenditures significantly decreased in youth with chronic pain from the year before initiating treatment to the following year in both intervention conditions, adjunctive internet cognitive-behavioral therapy and adjunctive internet education. Contrary to our hypothesis, the rate of change in health care costs over time was not significantly different between intervention conditions.
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Affiliation(s)
- Emily F Law
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.
| | - Cornelius B Groenewald
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Chuan Zhou
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington; Department of Psychiatry, University of Washington, Seattle, Washington
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17
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Kirby A, Judge D. Addressing the Inverse Care Law in Developmental Coordination Disorder and Related Neurodevelopmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2018. [DOI: 10.1007/s40474-018-0127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Eklund H, Findon J, Cadman T, Hayward H, Murphy D, Asherson P, Glaser K, Xenitidis K. Needs of Adolescents and Young Adults with Neurodevelopmental Disorders: Comparisons of Young People and Parent Perspectives. J Autism Dev Disord 2018; 48:83-91. [PMID: 28894999 PMCID: PMC5760588 DOI: 10.1007/s10803-017-3295-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
This study used the Camberwell Assessment of Need for adults with Developmental and Intellectual Disabilities (CANDID) to examine the social, physical health and mental health needs of 168 young people (aged 14-24 years) with neurodevelopmental disorders and compared young person and parent ratings of need. Agreement was poor in 21 out of 25 domains. Parents consistently reported higher levels of need than young people in the majority of domains although young people with ADHD reported significantly more needs in physical health, eyesight/hearing, seizures, other mental health problems and safety of others than their parents. Both parent and young person perspectives of needs are necessary to ensure that needs that are predictive of current or future poor outcomes are not missed.
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Affiliation(s)
- Hanna Eklund
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - James Findon
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Tim Cadman
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Hannah Hayward
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Philip Asherson
- MRC Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Karen Glaser
- Department of Social Sciences, Health and Medicine, Institute of Gerontology, King's College London, Strand, London, WC2R 2LS, UK
| | - Kiriakos Xenitidis
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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Caye A, Swanson J, Thapar A, Sibley M, Arseneault L, Hechtman L, Arnold LE, Niclasen J, Moffitt T, Rohde LA. Life Span Studies of ADHD-Conceptual Challenges and Predictors of Persistence and Outcome. Curr Psychiatry Rep 2016; 18:111. [PMID: 27783340 PMCID: PMC5919196 DOI: 10.1007/s11920-016-0750-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span.
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Affiliation(s)
- Arthur Caye
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - James Swanson
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Margaret Sibley
- Department of Psychiatry and Behavioral Health at the Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Louise Arseneault
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lily Hechtman
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - L Eugene Arnold
- Department of Psychiatry, Nisonger Center, Ohio State University, Columbus, OH, USA
| | - Janni Niclasen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Centre for Collaborative Health, Aarhus University, Aarhus, Denmark
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil.
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clinicas de Porto Alegre, 4o andar, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil.
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