Clinical profile and multidisciplinary needs of patients with neuromuscular disorders transitioning from paediatric to adult care
•Amongst patients with neuromuscular disorders transitioning from paediatric to adult care there was a broad range of disorders, with myopathy being the most common inherited disorder and myasthenia gravis in acquired.•A definite genetic diagnosis was achieved in a large proportion of patients.•Card...
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Veröffentlicht in: | Neuromuscular disorders : NMD 2022-03, Vol.32 (3), p.206-212 |
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description | •Amongst patients with neuromuscular disorders transitioning from paediatric to adult care there was a broad range of disorders, with myopathy being the most common inherited disorder and myasthenia gravis in acquired.•A definite genetic diagnosis was achieved in a large proportion of patients.•Cardiac and respiratory transitioning was performed in more than a third of patients and there was a strong correlation between scoliosis and the presence of respiratory abnormality.•A wide range of systemic issues required the services of endocrinology, gastroenterology, speech and language pathology and psychiatry.•A multidisciplinary clinical care model where all aspects of neuromuscular disease are addressed may provide optimal care for patients undergoing transition.
Transition in paediatric health care refers to the planned process of shifting to an adult model of care and is highly individualised, patient focussed and requires a coordinated effort from different health care professionals. Through this retrospective study, we describe the spectrum of neuromuscular diseases evaluated through a paediatric to adult neuromuscular transition program in a tertiary academic centre in Canada, and also the speciality supports needed for these patients. 126 patients were transitioned during the study period. The most common clinical diagnosis was muscle disease (44.4%), followed by neuropathy (27.8%), neuromuscular junction disorders (15.9%) and motor neuron disease (MND) (10.3%). The majority of cases were inherited neuromuscular disorders (66.6%); 58.3% had a genetically confirmed diagnosis. Cardiac and respiratory abnormalities were encountered in 8.7% and 27.7% and transitioning was required for 39.8% and 35.7% respectively. Scoliosis was seen in 30.2% of patients; 9.5% underwent spine surgery. Patients with MND had maximum requirements for self-care (46.2% of MND) and a mobility device for ambulation was required in 69.2% of MND. We observed a wide range of systemic issues requiring the services of endocrinology, gastroenterology, speech and language pathology and psychiatry. A multidisciplinary clinical care model may provide optimal care for patients transitioning from paediatric to adult care health systems. |
doi_str_mv | 10.1016/j.nmd.2021.12.002 |
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Transition in paediatric health care refers to the planned process of shifting to an adult model of care and is highly individualised, patient focussed and requires a coordinated effort from different health care professionals. Through this retrospective study, we describe the spectrum of neuromuscular diseases evaluated through a paediatric to adult neuromuscular transition program in a tertiary academic centre in Canada, and also the speciality supports needed for these patients. 126 patients were transitioned during the study period. The most common clinical diagnosis was muscle disease (44.4%), followed by neuropathy (27.8%), neuromuscular junction disorders (15.9%) and motor neuron disease (MND) (10.3%). The majority of cases were inherited neuromuscular disorders (66.6%); 58.3% had a genetically confirmed diagnosis. Cardiac and respiratory abnormalities were encountered in 8.7% and 27.7% and transitioning was required for 39.8% and 35.7% respectively. Scoliosis was seen in 30.2% of patients; 9.5% underwent spine surgery. Patients with MND had maximum requirements for self-care (46.2% of MND) and a mobility device for ambulation was required in 69.2% of MND. We observed a wide range of systemic issues requiring the services of endocrinology, gastroenterology, speech and language pathology and psychiatry. A multidisciplinary clinical care model may provide optimal care for patients transitioning from paediatric to adult care health systems.</description><identifier>ISSN: 0960-8966</identifier><identifier>EISSN: 1873-2364</identifier><identifier>DOI: 10.1016/j.nmd.2021.12.002</identifier><identifier>PMID: 35216880</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Adult ; Child ; Humans ; Motor Neuron Disease ; Muscle disease Multidisciplinary care ; Neuromuscular diseases ; Neuromuscular Diseases - therapy ; Paediatric ; Retrospective Studies ; Scoliosis - therapy ; Transition in health care ; Transition to Adult Care</subject><ispartof>Neuromuscular disorders : NMD, 2022-03, Vol.32 (3), p.206-212</ispartof><rights>2021 Elsevier B.V.</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c305t-f3debe50fcf671fd2525c2eeb29d63b3da90b64b55d57b83747f7ad8f6fb19323</cites><orcidid>0000-0002-9245-6341 ; 0000-0002-5805-4883</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0960896621007355$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35216880$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Menon, Deepak</creatorcontrib><creatorcontrib>Gonorazky, Hernan D.</creatorcontrib><creatorcontrib>Dowling, James J.</creatorcontrib><creatorcontrib>McAdam, Laura</creatorcontrib><creatorcontrib>Ansari, Tasjeel</creatorcontrib><creatorcontrib>Vajsar, Jiri</creatorcontrib><creatorcontrib>Yoon, Grace</creatorcontrib><creatorcontrib>Bril, Vera</creatorcontrib><creatorcontrib>Katzberg, Hans</creatorcontrib><title>Clinical profile and multidisciplinary needs of patients with neuromuscular disorders transitioning from paediatric to adult care</title><title>Neuromuscular disorders : NMD</title><addtitle>Neuromuscul Disord</addtitle><description>•Amongst patients with neuromuscular disorders transitioning from paediatric to adult care there was a broad range of disorders, with myopathy being the most common inherited disorder and myasthenia gravis in acquired.•A definite genetic diagnosis was achieved in a large proportion of patients.•Cardiac and respiratory transitioning was performed in more than a third of patients and there was a strong correlation between scoliosis and the presence of respiratory abnormality.•A wide range of systemic issues required the services of endocrinology, gastroenterology, speech and language pathology and psychiatry.•A multidisciplinary clinical care model where all aspects of neuromuscular disease are addressed may provide optimal care for patients undergoing transition.
Transition in paediatric health care refers to the planned process of shifting to an adult model of care and is highly individualised, patient focussed and requires a coordinated effort from different health care professionals. Through this retrospective study, we describe the spectrum of neuromuscular diseases evaluated through a paediatric to adult neuromuscular transition program in a tertiary academic centre in Canada, and also the speciality supports needed for these patients. 126 patients were transitioned during the study period. The most common clinical diagnosis was muscle disease (44.4%), followed by neuropathy (27.8%), neuromuscular junction disorders (15.9%) and motor neuron disease (MND) (10.3%). The majority of cases were inherited neuromuscular disorders (66.6%); 58.3% had a genetically confirmed diagnosis. Cardiac and respiratory abnormalities were encountered in 8.7% and 27.7% and transitioning was required for 39.8% and 35.7% respectively. Scoliosis was seen in 30.2% of patients; 9.5% underwent spine surgery. Patients with MND had maximum requirements for self-care (46.2% of MND) and a mobility device for ambulation was required in 69.2% of MND. We observed a wide range of systemic issues requiring the services of endocrinology, gastroenterology, speech and language pathology and psychiatry. A multidisciplinary clinical care model may provide optimal care for patients transitioning from paediatric to adult care health systems.</description><subject>Adult</subject><subject>Child</subject><subject>Humans</subject><subject>Motor Neuron Disease</subject><subject>Muscle disease Multidisciplinary care</subject><subject>Neuromuscular diseases</subject><subject>Neuromuscular Diseases - therapy</subject><subject>Paediatric</subject><subject>Retrospective Studies</subject><subject>Scoliosis - therapy</subject><subject>Transition in health care</subject><subject>Transition to Adult Care</subject><issn>0960-8966</issn><issn>1873-2364</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9PHCEchklTU1ftB-jFcOxlpvxZYCaezMa2Jia92DNh4EfLZgZWYDQ9-s3FrO2xJxJ43pe8D0KfKOkpofLLvo-L6xlhtKesJ4S9Qxs6KN4xLrfv0YaMknTDKOUpOitlTwgVSqoP6JQLRuUwkA163s0hBmtmfMjJhxmwiQ4v61yDC8WGQ3s2-Q-OAK7g5PHB1ACxFvwU6u92vea0rMWus8m4JVJ2kAuu2cQSakgxxF_YN6YFwQVTc7C4Jmxc-wJbk-ECnXgzF_j4dp6jn19v7nffu7sf325313ed5UTUznMHEwjirZeKescEE5YBTGx0kk_cmZFMcjsJ4YSaBq62yivjBi_9REfO-Dn6fOxtQx9WKFUvbSDMs4mQ1qKZ5HwQXHLVUHpEbU6lZPD6kMPSNGhK9Kt5vdfNvH41rynTzXzLXL7Vr9MC7l_ir-oGXB0BaCMfA2Td9EK0zUoGW7VL4T_1Lxu3mBY</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Menon, Deepak</creator><creator>Gonorazky, Hernan D.</creator><creator>Dowling, James J.</creator><creator>McAdam, Laura</creator><creator>Ansari, Tasjeel</creator><creator>Vajsar, Jiri</creator><creator>Yoon, Grace</creator><creator>Bril, Vera</creator><creator>Katzberg, Hans</creator><general>Elsevier B.V</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>7X8</scope><orcidid>https://orcid.org/0000-0002-9245-6341</orcidid><orcidid>https://orcid.org/0000-0002-5805-4883</orcidid></search><sort><creationdate>20220301</creationdate><title>Clinical profile and multidisciplinary needs of patients with neuromuscular disorders transitioning from paediatric to adult care</title><author>Menon, Deepak ; Gonorazky, Hernan D. ; Dowling, James J. ; McAdam, Laura ; Ansari, Tasjeel ; Vajsar, Jiri ; Yoon, Grace ; Bril, Vera ; Katzberg, Hans</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-f3debe50fcf671fd2525c2eeb29d63b3da90b64b55d57b83747f7ad8f6fb19323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Child</topic><topic>Humans</topic><topic>Motor Neuron Disease</topic><topic>Muscle disease Multidisciplinary care</topic><topic>Neuromuscular diseases</topic><topic>Neuromuscular Diseases - therapy</topic><topic>Paediatric</topic><topic>Retrospective Studies</topic><topic>Scoliosis - therapy</topic><topic>Transition in health care</topic><topic>Transition to Adult Care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Menon, Deepak</creatorcontrib><creatorcontrib>Gonorazky, Hernan D.</creatorcontrib><creatorcontrib>Dowling, James J.</creatorcontrib><creatorcontrib>McAdam, Laura</creatorcontrib><creatorcontrib>Ansari, Tasjeel</creatorcontrib><creatorcontrib>Vajsar, Jiri</creatorcontrib><creatorcontrib>Yoon, Grace</creatorcontrib><creatorcontrib>Bril, Vera</creatorcontrib><creatorcontrib>Katzberg, Hans</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neuromuscular disorders : NMD</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Menon, Deepak</au><au>Gonorazky, Hernan D.</au><au>Dowling, James J.</au><au>McAdam, Laura</au><au>Ansari, Tasjeel</au><au>Vajsar, Jiri</au><au>Yoon, Grace</au><au>Bril, Vera</au><au>Katzberg, Hans</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical profile and multidisciplinary needs of patients with neuromuscular disorders transitioning from paediatric to adult care</atitle><jtitle>Neuromuscular disorders : NMD</jtitle><addtitle>Neuromuscul Disord</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>32</volume><issue>3</issue><spage>206</spage><epage>212</epage><pages>206-212</pages><issn>0960-8966</issn><eissn>1873-2364</eissn><abstract>•Amongst patients with neuromuscular disorders transitioning from paediatric to adult care there was a broad range of disorders, with myopathy being the most common inherited disorder and myasthenia gravis in acquired.•A definite genetic diagnosis was achieved in a large proportion of patients.•Cardiac and respiratory transitioning was performed in more than a third of patients and there was a strong correlation between scoliosis and the presence of respiratory abnormality.•A wide range of systemic issues required the services of endocrinology, gastroenterology, speech and language pathology and psychiatry.•A multidisciplinary clinical care model where all aspects of neuromuscular disease are addressed may provide optimal care for patients undergoing transition.
Transition in paediatric health care refers to the planned process of shifting to an adult model of care and is highly individualised, patient focussed and requires a coordinated effort from different health care professionals. Through this retrospective study, we describe the spectrum of neuromuscular diseases evaluated through a paediatric to adult neuromuscular transition program in a tertiary academic centre in Canada, and also the speciality supports needed for these patients. 126 patients were transitioned during the study period. The most common clinical diagnosis was muscle disease (44.4%), followed by neuropathy (27.8%), neuromuscular junction disorders (15.9%) and motor neuron disease (MND) (10.3%). The majority of cases were inherited neuromuscular disorders (66.6%); 58.3% had a genetically confirmed diagnosis. Cardiac and respiratory abnormalities were encountered in 8.7% and 27.7% and transitioning was required for 39.8% and 35.7% respectively. Scoliosis was seen in 30.2% of patients; 9.5% underwent spine surgery. Patients with MND had maximum requirements for self-care (46.2% of MND) and a mobility device for ambulation was required in 69.2% of MND. We observed a wide range of systemic issues requiring the services of endocrinology, gastroenterology, speech and language pathology and psychiatry. A multidisciplinary clinical care model may provide optimal care for patients transitioning from paediatric to adult care health systems.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>35216880</pmid><doi>10.1016/j.nmd.2021.12.002</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9245-6341</orcidid><orcidid>https://orcid.org/0000-0002-5805-4883</orcidid></addata></record> |
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subjects | Adult Child Humans Motor Neuron Disease Muscle disease Multidisciplinary care Neuromuscular diseases Neuromuscular Diseases - therapy Paediatric Retrospective Studies Scoliosis - therapy Transition in health care Transition to Adult Care |
title | Clinical profile and multidisciplinary needs of patients with neuromuscular disorders transitioning from paediatric to adult care |
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