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Transitional Care in Pediatric Brain Tumor Patients: A Systematic Literature Review
Florian Ebel1, Ladina Greuter1, Raphael Guzman1,2,3
1Department of Neurosurgery, University Hospital of Basel, 4031 Basel, Switzerland.
Insights
As more pediatric brain tumor patients transition to adult care, efficient models are crucial. The "continued caregiver model" and "specialized clinic model" offer optimal care continuity.
Area of Science:
- Oncology
- Healthcare Management
- Patient Transition
Background:
- Advances in pediatric brain tumor (PBT) treatment lead to more survivors needing transition to adult healthcare.
- Efficient transitional models are essential for this growing patient population.
Purpose of the Study:
- To systematically review literature on PBT transition models.
- To identify effective strategies for managing the transitional period for PBT patients.
Main Methods:
- Systematic literature review of PubMed, Medline, and Embase databases up to January 2022.
- Inclusion of 15 studies from an initial 304 reviewed, focusing on PBT transition.
Main Results:
- Five transition models were identified, with "adult caregiver" and "joint caregiver" models being most common (45.5% each).
- Key patient challenges included adult healthcare professionals' lack of PBT knowledge (62.5%) and difficulty forming new relationships (37.5%).
Conclusions:
- Efficient transition models are mandatory for PBT patients, ensuring treatment and care continuity.
- "Continued caregiver model" for general PBT and "specialized clinic model" for NF1/TSC patients are optimal.
- Multidisciplinary communication is critical if specialized models are unavailable.
Background:
Due to advances in the treatment of pediatric brain tumors (PBT), an increasing number of patients are experiencing the transition from the pediatric to the adult health care system. This requires efficient transitional models.
Methods:
We systematically reviewed the literature regarding PBT concerning different transitional models and aspects of the transitional period. For this purpose, PubMed, Medline, and Embase databases were searched systematically through January 2022.
Results:
We reviewed a total of 304 studies, of which 15 were ultimately included. We identified five transition models described within the literature, while the most frequently mentioned ones were the "adult caregiver model" (45.5%), "joint caregiver model" (45.5%), "continued caregiver model" (27.3%), and the "specialized clinic model" (27.3%). During the transition, the most frequent challenges mentioned by the patients were the lack of knowledge about the disease by the adult health care professionals (62.5%) and the difficulty of establishing a new relationship with the new physician, environment, or hospital (37.5%).
Conclusions:
An efficient transitional model is mandatory for patients with PBT. Continuity in the treatment and care of the patient and their family is essential. For this purpose, in patients with PBT, the "continued caregiver model", and for NF1 and TSC patients, the "specialized clinic model" seems optimal to offer continuity of care. If such models are unavailable, efficient communication with patients, families, and specialists in a multidisciplinary network is even more critical.
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