Department of Psychology, Fordham University, Bronx, NY; Division of Behavioral and Developmental Health, Department of Pediatrics and Kravis Children's Hospital at the Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY.
J Pediatr. 2013 Dec;163(6):1628-33. doi: 10.1016/j.jpeds.2013.07.031. Epub 2013 Aug 29.
To compare the impact of a transition coordinator on outcomes for pediatric liver transplant recipients vs a historical comparison group.
To examine the utility of a transition coordinator, medication adherence, as measured by SDs of tacrolimus blood levels (Tacrolimus SD), was compared between the "transition coordinator group" (20 transplant recipients transferred between 2007 and 2012) and comparison group for 1 year before and after transfer. Measures of health care management, quality of life, and acceptability were administered to the transition coordinator group as well.
A repeated measures ANOVA was used to compare adherence values between the transition coordinator group and the comparison group. During the year before transfer, for the transition coordinator group, Tacrolimus SD was 1.98 (SD = 1.05) vs 3.25 (SD = 1.19) for comparison patients, F(1,25) = 4.77, P = .04. After transfer, levels remained stable for the transition coordinator group, Tacrolimus SD = 1.88 (SD = 1.57), but increased for comparison patients, Tacrolimus SD = 4.36 (SD = 0.99), F(1,25) = 6.99, P = .01. Psychosocial outcomes remained stable during the transfer period and acceptability was high.
Our findings, although limited by a small sample size, suggest that a transition coordinator is a promising method to improve this process.
比较过渡协调员对儿科肝移植受者结局的影响与历史对照的影响。
为了检验过渡协调员的效用，通过 Tacrolimus 血药浓度（Tacrolimus SD）的标准差来衡量药物的依从性，在 2007 年至 2012 年之间转移的“过渡协调员组”（20 例肝移植受者）与转移前和转移后 1 年的对照组之间进行比较。也向过渡协调员组提供了医疗管理、生活质量和可接受性的测量。
采用重复测量方差分析比较过渡协调员组和对照组的依从性值。在转移前的一年中，对于过渡协调员组，Tacrolimus SD 为 1.98（SD = 1.05），而对照组患者为 3.25（SD = 1.19），F（1，25）= 4.77，P =.04。转移后，过渡协调员组的水平保持稳定，Tacrolimus SD = 1.88（SD = 1.57），但对照组患者的 Tacrolimus SD 增加，Tacrolimus SD = 4.36（SD = 0.99），F（1，25）= 6.99，P =.01。在转移期间，心理社会结局保持稳定，可接受性较高。
尽管我们的研究结果受到样本量小的限制，但仍表明过渡协调员是改善这一过程的一种很有前途的方法。
