Abstract:
BACKGROUND:Transition guidelines and recommendations for developing countries are limited and best transition practices in young patients with chronic medical conditions have been poorly examined. This study evaluates transition practices from pediatric to adult rheumatology care in Brazil. METHODS:Practicing pediatric rheumatologists registered in the Brazilian Society of Rheumatology were e-surveyed with SurveyMonkey® using the Chira et al. questionnaire that had been used previously to evaluate transition practices of pediatric rheumatologists from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) in the USA and Canada. The questionnaire was modified to better address specific issues pertaining to the Brazilian health care system. RESULTS:Seventy-six of 112 (68%) pediatric rheumatologists responded. Only 13% of the respondents reported that they had a well-established transition program and only 14% were satisfied with their current transition process. Eighty percent did not use any specific tools to assess transition readiness. While 43% of respondents considered 18 as the ideal transition age, only a third effectively transitioned their patients at that age while 48% did later. Major hurdles for a successful transition cited by the respondents included emotional attachment to the patients (95%) insufficient training in transition practice (87%), lack of devoted time for transition preparation and process (80%), lack of assistance by pediatric generalists, (77%), and lack of available adult subspecialists (75%). Sixty-seven percent of respondents stated that their program would need more tools/resources to facilitate transition and 59% believed that the development of specific guidelines would be useful to standardize and help with the transition process. CONCLUSIONS:Our study demonstrates that the identified challenges pertaining to transition in Brazilian patients are similar to those reported by pediatric rheumatologists in the United States and Canada. However, the current financial economic pressures affecting Brazil's health care system may force physicians to deprioritize non emergent care such as transition. A comprehensive understanding of transition issues specific to youth in developing countries and educating not only patients but also health care providers about the importance of a seamless transition process will support the development of transition guidelines and ensure better outcomes of pediatric subspecialty patients.
journal_name
Pediatr Rheumatol Online Jjournal_title
Pediatric rheumatology online journalauthors
Anelli CG,Amorim ALM,Osaku FM,Terreri MT,Len CA,Reiff Adoi
10.1186/s12969-017-0176-ysubject
Has Abstractpub_date
2017-05-30 00:00:00pages
47issue
1issn
1546-0096pii
10.1186/s12969-017-0176-yjournal_volume
15pub_type
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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abstract:BACKGROUND:To assess the predictors for intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) in Kawasaki disease (KD). METHODS:A total of 560 KD patients were reviewed retrospectively, including 410 complete KD (cKD) and 150 incomplete KD (iKD) patients. The laboratory data were compared bet...
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
doi:10.1186/1546-0096-8-7
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pub_type: 杂志文章,评审
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journal_title:Pediatric rheumatology online journal
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
doi:10.1186/s12969-018-0257-6
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
doi:10.1186/1546-0096-7-21
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章,评审
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journal_title:Pediatric rheumatology online journal
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doi:10.1186/s12969-020-00453-6
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pub_type: 杂志文章
doi:10.1186/s12969-018-0240-2
更新日期:2018-04-10 00:00:00
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
doi:10.1186/1546-0096-5-2
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章,随机对照试验
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更新日期:2019-12-16 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12969-016-0116-2
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journal_title:Pediatric rheumatology online journal
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章,多中心研究
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章,评审
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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