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Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Transition of patients with Duchenne muscular dystrophy from paediatric to adult care: An international Delphi
Diana Castro1, Thomas Sejersen2, Luca Bello3
1Neurology & Neuromuscular Care Center/Neurology Rare Disease Center, Denton, TX, USA.
Insights
International guidelines were developed to improve the transition of care for young people with Duchenne muscular dystrophy (DMD) from pediatric to adult services. These recommendations ensure continued high-quality treatment and support for patients with DMD as they age.
Area of Science:
- Neurology
- Pediatrics
- Healthcare Management
Background:
- Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder impacting muscle function, ambulation, and vital organs.
- Increased life expectancy in DMD necessitates a structured transfer from pediatric to adult care.
- Clear guidelines are needed to manage this critical transition effectively.
Purpose of the Study:
- To establish international consensus guidelines for transitioning Duchenne muscular dystrophy patients from pediatric to adult care.
- To ensure continuity of treatment and optimize care standards during and after transition.
Main Methods:
- Utilized the Delphi process with 15 expert panellists to develop consensus statements.
- Employed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for scoring.
- Conducted three voting rounds, including systematic literature review and virtual consensus meetings.
Main Results:
- Achieved consensus on 48 statements guiding the transition process for Duchenne muscular dystrophy patients.
- Covered key areas: transition planning, process, post-transfer management, communication, and support.
- Established best practices for pediatric to adult care transfer in DMD.
Conclusions:
- The consensus statements offer a framework for enhancing transition practices in Duchenne muscular dystrophy care.
- Aims to promote seamless care and maintain high standards into adulthood.
- Supports young people with DMD in their journey to adult life and healthcare.
Background:
Duchenne muscular dystrophy (DMD) is a rare neuromuscular disorder characterized by a progressive decline in muscle function, leading to loss of ambulation, respiratory and cardiac failure, and ultimately death. Improvements in DMD management have increased patient life expectancy; therefore, there is a growing requirement for patients to transfer from paediatric to adult care services. There is also a need for clear recommendations to guide this process.
Aim:
To establish international consensus guidelines regarding best practices for transitioning patients with DMD from paediatric to adult care and ensuring continuity of treatment.
Methods:
Consensus statements were developed using the Delphi process and scored using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The initiative was led by a steering committee (one non-voting chair and two voting members) who recruited 15 expert panellists to form the consensus group. Following an initial systematic literature search, the consensus group voted in three voting rounds. Round 1 (free-text responses to questions) and Round 2 (importance ranking of statements) were completed using an online survey. Round 3 (voting on final consensus statements) took place during a virtual consensus meeting.
Consensus Statements:
Consensus was reached on 48 statements covering the topics of transition planning, the transition process, post-transfer management, communicating with young people with DMD and supporting them with the transition to adult life.
Conclusion:
These consensus statements provide guidelines for improving transition practices for young people with DMD and promoting continued care at a comparable standard in adulthood.
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