Pedersen Maria, Höybye Charlotte
Department of Endocrinology, Karolinska University Hospital, 171 76 Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institute, 171 76 Stockholm, Sweden.
J Clin Med. 2021 May 6;10(9):1991. doi: 10.3390/jcm10091991.
Prader-Willi syndrome (PWS) is a rare, neurodevelopmental, genetic disease caused by the lack of expression of paternal genes in chromosome 15. The typical characteristics, including hyperphagia, muscular hypotonia, abnormal body composition, hormonal deficiencies, cognitive disabilities, and behavioral problems, appear or worsen in young adults, and the development of comorbidities increases. The transition of care of young adults with PWS is a challenge due to the complexity of the disease and the vulnerability of the patients. Multidisciplinary transition clinics are optimal but difficult to implement in clinics with few transitions.
The description of transition care meetings was limited to the pediatric and adult endocrinologists and nurses. The presentation of our checklist was developed to optimize the organization of the transition of young adults with PWS.
Two to four patients with PWS are transferred to adult care every year in our hospital. Transition with the adapted program was more comfortable for patients and identification of the individual patient's comorbidities and special needs could clearly be addressed.
In smaller settings, an adapted model including a proper introduction and presentation of the adult team and clinic, careful information about comorbidities and special needs, together with a checklist can optimize the transition of care to adult care.
普拉德-威利综合征(PWS)是一种罕见的神经发育性遗传疾病,由15号染色体上父源基因表达缺失引起。其典型特征包括食欲亢进、肌张力低下、身体成分异常、激素缺乏、认知障碍和行为问题,这些特征在年轻人中会出现或加重,且合并症的发生率增加。由于该疾病的复杂性和患者的脆弱性,PWS青年患者的护理过渡是一项挑战。多学科过渡诊所是最佳选择,但在过渡病例较少的诊所难以实施。
过渡护理会议的描述仅限于儿科和成人内分泌科医生及护士。我们制定了检查表,以优化PWS青年患者过渡的组织工作。
我院每年有2至4名PWS患者转诊至成人护理。采用适应性方案进行过渡对患者来说更轻松,且能明确解决个体患者的合并症和特殊需求。
在规模较小的医疗机构中,一种适应性模式,包括向成人团队和诊所进行适当介绍和展示、仔细告知合并症和特殊需求,再加上一份检查表,可以优化向成人护理的过渡。