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Pediatric to Adult Hydrocephalus: A Smooth Transition
Manilyn A Hong1, Arvind Sukumaran1, Jay Riva-Cambrin1
1Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Insights
Transitioning pediatric hydrocephalus patients to adult care requires addressing patient, provider, and system barriers. Early planning and tailored policies are crucial for successful lifelong management of this chronic neurological condition.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Healthcare Transition
Background:
- Pediatric hydrocephalus patients need lifelong care for disease and treatment sequelae.
- Seamless transition from pediatric to adult healthcare is a significant challenge for neurosurgeons.
Purpose of the Study:
- To review literature on transitioning pediatric patients with chronic conditions to adult care.
- To identify barriers and successful models for hydrocephalus patients transitioning to adult neurosurgical care.
Main Methods:
- Literature review focusing on pediatric chronic condition transition and hydrocephalus-specific transition challenges.
- Analysis of barriers and essential elements for successful transition policies.
Main Results:
- Identified barriers include patient, cultural, provider, and healthcare system factors.
- Six key elements for successful transitions were identified: policy, tracking, readiness, planning, transfer, and completion.
- Transition success is center-specific, influenced by resources and environment.
Conclusions:
- Transition policies must be tailored to individual healthcare settings, especially in resource-poor environments.
- Recommendations include early transition initiation, ideally by age 14.
- A structured approach is vital for lifelong hydrocephalus management.
Introduction:
Pediatric patients treated for hydrocephalus, regardless of etiology, require continuous access to care to address the long-term sequelae from the disease progression itself and from the interventions undertaken. The challenge for all pediatric neurosurgeons is providing comprehensive and coordinated care for these patients in order to achieve a smooth and seamless transition into adult health care.
Methods:
A review of the literature was conducted regarding the overall concept of pediatric patients with chronic conditions transitioning to adult care. We also specifically reviewed the pediatric hydrocephalus literature to investigate the barriers of transition, models of success, and specific elements required in a transition policy.
Results:
The review identified several barriers that hamper smooth and successful transition from pediatric to adult care within the hydrocephalus population. These included patient-related, cultural/society-related, healthcare provider-related, and healthcare system-related barriers. Six elements for successful transitions were noted: transition policy, tracking and monitoring, transition readiness, transition planning, transfer of care, and transition completion stemming from the Got Transition center.
Conclusions:
A successful patient transition from pediatric neurosurgical care to adult neurosurgical care is very center-specific and depends on the available resources within that center's hospital, health system, and geo-economic environment. Six recommendations are made for transition policy implementation in resource-poor environments, including beginning the process early, preferably at age 14 years.
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