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Transitional Care for Young People with Neurological Disorders: A Scoping Review with A Focus on Patients with
Eavan McGovern1, Tamara Pringsheim2, Alex Medina2
1Dublin Neurological Institute, Mater University Hospital, Dublin, Ireland.
Insights
Transitioning young adults with childhood-onset movement disorders to adult care presents challenges. Improved preparation, consistent practices, and enhanced adult services are crucial for better patient outcomes.
Area of Science:
- Neurology
- Pediatrics
- Healthcare Transition
Background:
- Childhood-onset movement disorders are complex neurological conditions.
- Care transition from pediatric to adult medicine is critical for these patients.
Purpose of the Study:
- To review literature on transitional care for chronic neurological diseases.
- To identify gaps in knowledge regarding young adults with childhood-onset movement disorders.
Main Methods:
- Scoping review of 64 articles.
- Qualitative synthesis of transitional care issues and models.
- Focused analysis on movement disorder patients.
Main Results:
- Identified 4 key transitional issues: inadequate preparation, inconsistent practices, insufficient adult services, and emotional distress.
- Multidisciplinary ambulatory care was the most common model.
- Few studies included patients with movement disorders.
Conclusions:
- Existing literature highlights critical issues in care transition.
- Further research is needed on transitional care programs' effectiveness and cost-effectiveness.
- Specific needs and outcomes for childhood-onset movement disorders require more investigation.
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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