Transition to adult care in epilepsy: A systematic review
Rianne J M Goselink1, Ingrid Olsson2, Kristina Malmgren3
1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden; Division of Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Insights
Transitioning young people with epilepsy from pediatric to adult care is crucial for long-term outcomes. Planned transition processes show benefits, but evidence is limited, highlighting a need for more research.
Area of Science:
- Neurology
- Healthcare Management
- Pediatrics
Background:
- Transitioning children with epilepsy to adult care is complex and impacts long-term health.
- Inadequate transitional care can negatively affect medical and psychosocial outcomes for young people with epilepsy.
Purpose of the Study:
- To systematically review existing literature on transitional care for young persons with epilepsy.
- To synthesize evidence for best practices in epilepsy transitional care.
Main Methods:
- Systematic review following PRISMA guidelines.
- Narrative synthesis of 36 included articles (11 interventional, 25 observational).
- Assessment of study quality.
Main Results:
- Interventions like multidisciplinary clinics and patient education showed positive effects.
- Transition plans are often lacking or not tailored for individuals with intellectual disability or neurodevelopmental conditions.
- Only four studies were rated as 'good' quality.
Conclusions:
- A planned transition process likely improves medical and psychosocial outcomes for young people with epilepsy.
- Limited evidence and knowledge gaps exist regarding effective transitional care components.
- Further research with robust designs and mixed methods is needed to explore needs and intervention impacts.
Abstract:
The transfer from paediatric to adult care can be a complex process in children with epilepsy. Inadequate care during this phase can affect long-term medical and psychosocial outcomes. The aim of this study was to review studies on transitional care from paediatric to adult healthcare for young persons with epilepsy in order to synthesize evidence for best practice. We undertook a systematic review following PRISMA guidelines and employed narrative synthesis. A total of 36 articles were included, of which 11 were interventional studies and 25 observational studies. Study quality was rated as 'good' for only four studies. Interventions included joint or multidisciplinary clinics, education (patient and health professional education) and extended service provision (Saturday clinics, peer-groups). All studies observed a positive effect experienced by the participants, regardless of intervention type. Observational studies showed that transition plans/programmes are asked for but frequently not existing or not adapted to subgroups with intellectual disability or other neurodevelopmental conditions. The results of this systematic review on transitional care in epilepsy suggest that a planned transition process likely enhances medical and psychosocial outcomes for young people with epilepsy, but the body of evidence is limited and there are significant gaps in knowledge of what efficacious transition constitutes. More studies are needed employing qualitative and quantitative methods to further explore the needs of young people with epilepsy and their families but also robust study designs to investigate the impact of interventions on medical and psychosocial outcomes.
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