Challenges in the Transition of Care Process for Patients with Dravet and Lennox–Gastaut Syndromes

IF 0.2 Q4 PEDIATRICS Journal of Pediatric Epilepsy Pub Date : 2020-09-11 DOI:10.1055/s-0040-1716670
Cemal Karakas, R. Schultz, Jay R. Gavvala
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Abstract

Abstract Epileptic encephalopathies such as Dravet syndrome (DS) and Lennox–Gastaut syndrome (LGS) present unique challenges in the transition of care not only for the providers but also for the patients and families. Some of these challenges include the complexity of disease process, differences in medication management between children and adults, high incidence of comorbidities such as psychosocial issues, a lack of structured transition process from pediatric to adult care, and the lack of parental knowledge and reluctance to transition to an adult provider. Improving transition readiness and transfer of care are essential to long-term management and continuity of care. Studies show that patients/families who possess transition readiness skills have better health outcomes. Furthermore, participation in a structured transition intervention has been shown to improve transition readiness and utilization of ambulatory care in the adult setting. Reported benefits of implementation of transition planning include increased self-esteem, improved health literacy, fewer emergency room visits, decreased hospitalizations and comorbidities, and fewer school absences. Nevertheless, there is a lack of evidenced-based, family/patient-centered transition model of care. This review's primary goal is to provide an overview of challenges in the transition of care and recommendations for an ideal transition for patients with DS and LGS.
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Dravet综合征和lenox - gastaut综合征患者护理过程转变中的挑战
癫痫性脑病,如Dravet综合征(DS)和lenox - gastaut综合征(LGS)提出了独特的挑战,在护理的过渡,不仅为提供者,也为患者和家属。其中一些挑战包括疾病过程的复杂性,儿童和成人之间药物管理的差异,社会心理问题等合并症的高发,缺乏从儿科到成人护理的结构化过渡过程,以及父母缺乏知识和不愿过渡到成人提供者。改善过渡准备和转移护理对护理的长期管理和连续性至关重要。研究表明,拥有过渡准备技能的患者/家庭有更好的健康结果。此外,参与结构化的过渡干预已被证明可以改善成人环境中的过渡准备和门诊护理的利用。据报告,实施过渡规划的好处包括增强自尊、提高健康素养、减少急诊室就诊、减少住院和合并症以及减少缺勤。然而,缺乏以证据为基础的、以家庭/病人为中心的护理过渡模式。本综述的主要目的是概述退行性椎体滑移和LGS患者在护理过渡过程中面临的挑战,并为理想的过渡提供建议。
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期刊介绍: The Journal of Pediatric Epilepsy is an English multidisciplinary peer-reviewed international journal publishing articles on all topics related to epilepsy and seizure disorders, epilepsy surgery, neurology, neurosurgery, and neuropsychology in childhood. These topics include the basic sciences related to the condition itself, the differential diagnosis, natural history, and epidemiology of seizures, and the investigation and practical management of epilepsy (including drug treatment, neurosurgery and non-medical and behavioral treatments). Use of model organisms and in vitro techniques relevant to epilepsy are also acceptable. Journal of Pediatric Epilepsy provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques used in the diagnosis and treatment of childhood epilepsy.
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