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[Transition of Children with Epilepsy to Adult Care: Current Status and Challenge]
1National Hospital Organization, Shizuoka Institute of Epilepsy and Neurological Disorders.
Insights
Many adult patients with childhood-onset epilepsy struggle with transitioning to adult care due to a lack of suitable clinics and physician expertise. Successful transition requires patient-centered care, psychosocial support, and improved medical system organization.
Area of Science:
- Neurology
- Pediatric Neurology
- Epilepsy Management
Background:
- Thirty percent of pediatric neurology patients are adults who resist transfer to adult clinics due to unsuitable facilities.
- Pediatric neurologists lack expertise in adult psychiatric/psychological symptoms and common adult diseases.
- Adult neurologists struggle with childhood epilepsy history and syndromes, hindering comprehensive care.
Purpose of the Study:
- To highlight the challenges in transitioning adult patients with childhood-onset epilepsy.
- To emphasize the need for a patient-centered approach in epilepsy care transition.
- To identify key components for successful transition from pediatric to adult neurological care.
Main Methods:
- Literature review on transition challenges in epilepsy care.
- Analysis of the complexities faced by pediatric and adult neurologists.
- Identification of essential elements for patient-centered transition.
Main Results:
- Significant difficulties exist in transferring adult patients with childhood-onset epilepsy.
- Lack of specialized adult clinics and physician familiarity with specific epilepsy histories impede care.
- Patient-centered transition requires flexibility, responsiveness, continuity, comprehensiveness, and coordination.
Conclusions:
- Successful transition necessitates prioritizing patient decisions and providing robust psychosocial support.
- Enhanced medical system organization, including transition clinics and specialized staff, is crucial.
- Resources like checklists and programs can significantly aid the transition process for epilepsy patients.
Abstract:
Thirty percent of the patients consulting a pediatric neurologist have already reached adulthood as patients and their families do not like transfer to the adult clinics; moreover, there are no suitable clinics. Pediatric neurologists find it difficult to examine adult patients with childhood-onset epilepsy as they are unfamiliar with the psychiatric and psychological symptoms manifested in adulthood, and the common diseases of adulthood. On the other hand, adult neurologists have difficulty obtaining a complete picture of the patient's clinical history since childhood, and are unfamiliar with childhood-specific epilepsy syndrome. When it comes to transition, the patient's decision should be prioritized. Transition should be patient-centered, with cornerstones of flexibility, responsiveness, continuity, comprehensiveness, and coordination. For successful transition to occur, there must be psychosocial support, patient education, better medical system organization with inclusion of a transition process, such as transition clinic, increased number of epilepsy-specialized physicians/nurses, and resources such as checklists and programs to aid in transition.