Shearer Jennifer Lynne, Perry Sharon, Lidyard Nicole, Apperson-Hensen Carolyn, DeLozier Sarah, Burkhart Kimberly, Katz Jeffry, Moses Jonathan
School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
UH/Rainbow Babies Children's Pediatric Gastroenterology, University Hospitals Cleveland, Cleveland, OH 44106, USA.
Children (Basel). 2020 Dec 4;7(12):271. doi: 10.3390/children7120271.
To reduce lapses in care for pediatric inflammatory bowel disease (IBD) patients approaching adulthood, a health maintenance transition visit (HMV) was developed to supplement standard medical care (SMV). Our aim was to assess the effect of the HMV on transition readiness. A retrospective chart review was conducted at a single center with demographics and clinical data from HMV and SMV visits. Effectiveness of the HMV was assessed by the patient health questionanaire-9 (PHQ-9) and transition readiness assessment questionnaire (TRAQ) scores. A total of 140 patients, 80% Caucasian and 59% male completed an HMV. The mean age was 18 ± 2 years old, and 93% of patients reported inactive or mild disease. Patients who completed at least 1 prior HMV scored significantly higher on the TRAQ when transferring to adult care compared to patients transferred at their first HMV visit (92 vs. 83, < 0.05). Of patients with no prior depression diagnosis, 36% had a positive screen for depression. A significant relationship was identified between disease status and PHQ-9 ( < 0.05). This study demonstrated a structured HMV increased transition readiness and quantified the significant under-diagnosis of depression in this population, emphasizing the importance of screening. These results indicate depression may affect patients' transition preparedness.
为减少接近成年的小儿炎症性肠病(IBD)患者护理过程中的失误,开发了健康维护过渡访视(HMV)以补充标准医疗护理(SMV)。我们的目的是评估HMV对过渡准备情况的影响。在一个单一中心进行了回顾性病历审查,收集了HMV和SMV访视的人口统计学和临床数据。通过患者健康问卷-9(PHQ-9)和过渡准备情况评估问卷(TRAQ)得分评估HMV的有效性。共有140名患者完成了HMV,其中80%为白种人,59%为男性。平均年龄为18±2岁,93%的患者报告疾病处于非活动或轻度状态。与首次进行HMV访视时转诊的患者相比,至少提前完成1次HMV的患者在转诊至成人护理时TRAQ得分显著更高(92对83,<0.05)。在既往无抑郁症诊断的患者中,36%的患者抑郁症筛查呈阳性。疾病状态与PHQ-9之间存在显著相关性(<0.05)。本研究表明,结构化的HMV提高了过渡准备情况,并量化了该人群中抑郁症的显著漏诊情况,强调了筛查的重要性。这些结果表明抑郁症可能会影响患者的过渡准备情况。