Transitioning from paediatric to adult services with cystic fibrosis or bronchiectasis: What is the impact on engagement and health outcomes?
Aim To determine whether the transfer of young people with cystic fibrosis (CF) or bronchiectasis from paediatric to adult services is associated with changes in service engagement and/or health outcomes. Methods Young people aged ≥15 years of age with CF or bronchiectasis who transferred from the A...
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Veröffentlicht in: | Journal of paediatrics and child health 2021-04, Vol.57 (4), p.548-553 |
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creator | Moss, Rochelle Farrant, Bridget Byrnes, Catherine A |
description | Aim
To determine whether the transfer of young people with cystic fibrosis (CF) or bronchiectasis from paediatric to adult services is associated with changes in service engagement and/or health outcomes.
Methods
Young people aged ≥15 years of age with CF or bronchiectasis who transferred from the Auckland‐based paediatric service (Starship Children's Hospital) to one of three Auckland‐based District Health Boards between 2005 and 2012 were identified and included if they had 3 years care both pre‐transfer and post‐transfer care. Transfer preparation, service engagement (clinics scheduled, clinics attended) and health outcomes (lung function, hospitalisations) were collected per annum.
Results
Fifty‐seven young people transferred in this period with 46 meeting inclusion criteria (CF n = 20, bronchiectasis n = 26). The CF group had better transfer documentation, were transferred at an older age (11 months older P |
doi_str_mv | 10.1111/jpc.15264 |
format | Article |
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To determine whether the transfer of young people with cystic fibrosis (CF) or bronchiectasis from paediatric to adult services is associated with changes in service engagement and/or health outcomes.
Methods
Young people aged ≥15 years of age with CF or bronchiectasis who transferred from the Auckland‐based paediatric service (Starship Children's Hospital) to one of three Auckland‐based District Health Boards between 2005 and 2012 were identified and included if they had 3 years care both pre‐transfer and post‐transfer care. Transfer preparation, service engagement (clinics scheduled, clinics attended) and health outcomes (lung function, hospitalisations) were collected per annum.
Results
Fifty‐seven young people transferred in this period with 46 meeting inclusion criteria (CF n = 20, bronchiectasis n = 26). The CF group had better transfer documentation, were transferred at an older age (11 months older P < 0.0001 95%CI: 6.7 months, 14.7 months), were 20 times more likely to attend clinics (P < 0.0001, 95%CI: 7.8, 66.1) and had 3–4 more clinics scheduled pre‐transfer (P < 0.0001, 95%CI: 3.4, 4.9) and post‐transfer (P < 0.0001, 95%CI: 2.4, 3.8) despite having less severe respiratory disease as measured by FEV1 for each year (P < 0.01, 95%CI: 0.34, 1.22).
Conclusion
The transfer of young people with CF to adult services did not affect health engagement or outcomes, in contrast to those with bronchiectasis. Use of a formalised transfer process, more clinic appointments offered and greater resources for CF may be responsible for this difference. Comprehensive transition with purposeful, planned movement and developmentally appropriate care is a key goal.</description><identifier>ISSN: 1034-4810</identifier><identifier>EISSN: 1440-1754</identifier><identifier>DOI: 10.1111/jpc.15264</identifier><identifier>PMID: 33185946</identifier><language>eng</language><publisher>Australia: John Wiley & Sons Australia, Ltd</publisher><subject>Adolescent ; Adult ; Aged ; bronchiectasis ; Bronchiectasis - therapy ; Child ; Cystic fibrosis ; Cystic Fibrosis - therapy ; Health behavior ; Hospitals, Pediatric ; Humans ; Infant ; Motivation ; Outcome Assessment, Health Care ; Patient compliance ; Pediatrics ; respiratory ; Respiratory diseases ; Teenagers ; transition ; Transitions ; Young adults</subject><ispartof>Journal of paediatrics and child health, 2021-04, Vol.57 (4), p.548-553</ispartof><rights>2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)</rights><rights>2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).</rights><rights>2021 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-772676fa1242827ebc2001e3aaa041e275f358dc5df963bba18884d83f8804543</citedby><cites>FETCH-LOGICAL-c3534-772676fa1242827ebc2001e3aaa041e275f358dc5df963bba18884d83f8804543</cites><orcidid>0000-0002-5100-0524</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjpc.15264$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjpc.15264$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33185946$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moss, Rochelle</creatorcontrib><creatorcontrib>Farrant, Bridget</creatorcontrib><creatorcontrib>Byrnes, Catherine A</creatorcontrib><title>Transitioning from paediatric to adult services with cystic fibrosis or bronchiectasis: What is the impact on engagement and health outcomes?</title><title>Journal of paediatrics and child health</title><addtitle>J Paediatr Child Health</addtitle><description>Aim
To determine whether the transfer of young people with cystic fibrosis (CF) or bronchiectasis from paediatric to adult services is associated with changes in service engagement and/or health outcomes.
Methods
Young people aged ≥15 years of age with CF or bronchiectasis who transferred from the Auckland‐based paediatric service (Starship Children's Hospital) to one of three Auckland‐based District Health Boards between 2005 and 2012 were identified and included if they had 3 years care both pre‐transfer and post‐transfer care. Transfer preparation, service engagement (clinics scheduled, clinics attended) and health outcomes (lung function, hospitalisations) were collected per annum.
Results
Fifty‐seven young people transferred in this period with 46 meeting inclusion criteria (CF n = 20, bronchiectasis n = 26). The CF group had better transfer documentation, were transferred at an older age (11 months older P < 0.0001 95%CI: 6.7 months, 14.7 months), were 20 times more likely to attend clinics (P < 0.0001, 95%CI: 7.8, 66.1) and had 3–4 more clinics scheduled pre‐transfer (P < 0.0001, 95%CI: 3.4, 4.9) and post‐transfer (P < 0.0001, 95%CI: 2.4, 3.8) despite having less severe respiratory disease as measured by FEV1 for each year (P < 0.01, 95%CI: 0.34, 1.22).
Conclusion
The transfer of young people with CF to adult services did not affect health engagement or outcomes, in contrast to those with bronchiectasis. Use of a formalised transfer process, more clinic appointments offered and greater resources for CF may be responsible for this difference. Comprehensive transition with purposeful, planned movement and developmentally appropriate care is a key goal.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>bronchiectasis</subject><subject>Bronchiectasis - therapy</subject><subject>Child</subject><subject>Cystic fibrosis</subject><subject>Cystic Fibrosis - therapy</subject><subject>Health behavior</subject><subject>Hospitals, Pediatric</subject><subject>Humans</subject><subject>Infant</subject><subject>Motivation</subject><subject>Outcome Assessment, Health Care</subject><subject>Patient compliance</subject><subject>Pediatrics</subject><subject>respiratory</subject><subject>Respiratory diseases</subject><subject>Teenagers</subject><subject>transition</subject><subject>Transitions</subject><subject>Young adults</subject><issn>1034-4810</issn><issn>1440-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhiMEohdY8ALIEhu6mNbXxMOmQiNuVSVYFLG0TpyTiUeJHWyHah6Cd8YwbRdI9cZH53z6ZJ-_ql4xes7KudjN9pwpXssn1TGTkq5Yo-TTUlMhV1IzelSdpLSjlHKl9PPqSAim1VrWx9Xvmwg-ueyCd35L-hgmMgN2DnJ0luRAoFvGTBLGX85iIrcuD8TuUy7T3rUxJJdIiKRU3g4ObYbSeUd-DJBJGeUBiZtmsJkET9BvYYsT-kzAd2RAGIsuLNmGCdPli-pZD2PCl3f3afX944ebzefV9ddPXzbvr1dWqPKlpuF1U_fAuOSaN9haTilDAQBUMuSN6oXSnVVdv65F2wLTWstOi15rKpUUp9Xbg3eO4eeCKZvJJYvjCB7DkgyXNW0aypQu6Jv_0F1Yoi-vM1zRNWc1VaJQZwfKloWkiL2Zo5sg7g2j5m9GpmRk_mVU2Nd3xqWdsHsg70MpwMUBuHUj7h83matvm4PyD0gJnAA</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Moss, Rochelle</creator><creator>Farrant, Bridget</creator><creator>Byrnes, Catherine A</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5100-0524</orcidid></search><sort><creationdate>202104</creationdate><title>Transitioning from paediatric to adult services with cystic fibrosis or bronchiectasis: What is the impact on engagement and health outcomes?</title><author>Moss, Rochelle ; Farrant, Bridget ; Byrnes, Catherine A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-772676fa1242827ebc2001e3aaa041e275f358dc5df963bba18884d83f8804543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>bronchiectasis</topic><topic>Bronchiectasis - therapy</topic><topic>Child</topic><topic>Cystic fibrosis</topic><topic>Cystic Fibrosis - therapy</topic><topic>Health behavior</topic><topic>Hospitals, Pediatric</topic><topic>Humans</topic><topic>Infant</topic><topic>Motivation</topic><topic>Outcome Assessment, Health Care</topic><topic>Patient compliance</topic><topic>Pediatrics</topic><topic>respiratory</topic><topic>Respiratory diseases</topic><topic>Teenagers</topic><topic>transition</topic><topic>Transitions</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moss, Rochelle</creatorcontrib><creatorcontrib>Farrant, Bridget</creatorcontrib><creatorcontrib>Byrnes, Catherine A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of paediatrics and child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moss, Rochelle</au><au>Farrant, Bridget</au><au>Byrnes, Catherine A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transitioning from paediatric to adult services with cystic fibrosis or bronchiectasis: What is the impact on engagement and health outcomes?</atitle><jtitle>Journal of paediatrics and child health</jtitle><addtitle>J Paediatr Child Health</addtitle><date>2021-04</date><risdate>2021</risdate><volume>57</volume><issue>4</issue><spage>548</spage><epage>553</epage><pages>548-553</pages><issn>1034-4810</issn><eissn>1440-1754</eissn><abstract>Aim
To determine whether the transfer of young people with cystic fibrosis (CF) or bronchiectasis from paediatric to adult services is associated with changes in service engagement and/or health outcomes.
Methods
Young people aged ≥15 years of age with CF or bronchiectasis who transferred from the Auckland‐based paediatric service (Starship Children's Hospital) to one of three Auckland‐based District Health Boards between 2005 and 2012 were identified and included if they had 3 years care both pre‐transfer and post‐transfer care. Transfer preparation, service engagement (clinics scheduled, clinics attended) and health outcomes (lung function, hospitalisations) were collected per annum.
Results
Fifty‐seven young people transferred in this period with 46 meeting inclusion criteria (CF n = 20, bronchiectasis n = 26). The CF group had better transfer documentation, were transferred at an older age (11 months older P < 0.0001 95%CI: 6.7 months, 14.7 months), were 20 times more likely to attend clinics (P < 0.0001, 95%CI: 7.8, 66.1) and had 3–4 more clinics scheduled pre‐transfer (P < 0.0001, 95%CI: 3.4, 4.9) and post‐transfer (P < 0.0001, 95%CI: 2.4, 3.8) despite having less severe respiratory disease as measured by FEV1 for each year (P < 0.01, 95%CI: 0.34, 1.22).
Conclusion
The transfer of young people with CF to adult services did not affect health engagement or outcomes, in contrast to those with bronchiectasis. Use of a formalised transfer process, more clinic appointments offered and greater resources for CF may be responsible for this difference. Comprehensive transition with purposeful, planned movement and developmentally appropriate care is a key goal.</abstract><cop>Australia</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>33185946</pmid><doi>10.1111/jpc.15264</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-5100-0524</orcidid></addata></record> |
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subjects | Adolescent Adult Aged bronchiectasis Bronchiectasis - therapy Child Cystic fibrosis Cystic Fibrosis - therapy Health behavior Hospitals, Pediatric Humans Infant Motivation Outcome Assessment, Health Care Patient compliance Pediatrics respiratory Respiratory diseases Teenagers transition Transitions Young adults |
title | Transitioning from paediatric to adult services with cystic fibrosis or bronchiectasis: What is the impact on engagement and health outcomes? |
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