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Outcomes following a multi-disciplinary pediatric-to-adult transition and transfer clinic at a level four epilepsy
Selina S Vickery1, Sarita Maturu2, Nabil Khandker2
1The Ohio State University College of Medicine, Columbus, Ohio, USA.
Insights
A new epilepsy transition clinic improved patient follow-up and retention in adult care. This novel model enhances continuity of care for young adults with lifelong epilepsy, including complex cases.
Area of Science:
- Neurology
- Healthcare Management
- Patient Transition Care
Background:
- Transitioning patients from pediatric to adult healthcare is vital for individuals with lifelong conditions.
- Effective transition models are needed to ensure continued health and well-being.
- Epilepsy requires specialized, long-term management, making transition care critical.
Purpose of the Study:
- To evaluate the impact of a novel epilepsy transition collaboration between Nationwide Children's Hospital (NCH) and Ohio State University (OSU) Wexner Medical Center.
- To assess the effectiveness of a dedicated epilepsy transition and transfer clinic model.
- To determine if the new model improves continuity of care for epilepsy patients.
Main Methods:
- Retrospective analysis of 56 consecutive epilepsy patients transferred to adult care.
- Comparison of two cohorts: 23 patients pre-clinic implementation (2019) and 33 patients post-implementation (2019-2020).
- Data collected included demographics, age at transfer, epilepsy type, treatment resistance, surgical history, and follow-up compliance.
Main Results:
- Patients using the transition clinic were significantly more likely to be followed at OSU within 6 months (p=.013).
- Improved patient retention at OSU was observed following the implementation of the transition clinic (p=.037).
- The clinic successfully managed medically complex patients, including those with pharmacoresistant or genetic epilepsy.
Conclusions:
- This study provides the first statistically significant data on improved care through an epilepsy transition clinic.
- The novel clinic model enhances continuity of care for at-risk youth and young adults with epilepsy.
- The approach shows potential for improving healthcare outcomes and supporting adult epilepsy subspecialty practice growth.
Objective:
Transition and transfer from the pediatric to adult care model is crucial to the continued long-term health and well-being of patients impacted by life-long diseases. This project explores the impact of a novel epilepsy transition collaboration between Nationwide Children's Hospital (NCH) and Ohio State University (OSU) Wexner Medical Center.
Methods:
We retrospectively analyzed the characteristics and outcomes of 56 consecutive patients transferred to an adult health care system. These patients were divided into two groups. A cohort of 23 patients transferred in 2019 prior to clinic implementation were compared to a cohort of 33 consecutive patients transferred in 2019 and early 2020 using the epilepsy transition and transfer clinic model. Data points of interest included demographic information, age at transfer, epilepsy diagnosis, pharmacoresistance of epilepsy, surgical history and compliance with follow-up.
Results:
Patients transferred to OSU through the transition clinic were statistically more likely to be followed at OSU (p = .037) within 6 months (p = .013). Additionally, there was improved patient retention at OSU following transition clinic implementation (p = .037).
Significance:
Data demonstrating statistically significant improvement in care has not been reported for an epilepsy transition clinic. This study establishes that our novel approach improves continuity of care in this at-risk population. Our clinic model also successfully transitioned and transferred medically complex patients, including those with pharmacoresistant and/or genetically mediated epilepsy. Additionally, this work suggests that this clinic structure has potential to foster the growth of associated adult epilepsy subspecialty practices. These findings are encouraging as they offer potential for improved health care in the youth and young adult epilepsy population.
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