Dufrois Caroline, Bourgoin-Heck Mélisande, Lambert Nathalie, Just Jocelyne, Bregeon Aurore, Taillé Camille, Wanin Stéphanie
Department of Paediatric Allergology, Armand Trousseau University Hospital, Groupe Hospitalier Universitaire, AP-HP Sorbonne-Université, Paris, France.
Transversal Unit of Therapeutic Education of the Patient, Sorbonne University, Paris, France.
J Asthma Allergy. 2022 Mar 6;15:327-340. doi: 10.2147/JAA.S348369. eCollection 2022.
The prevalence of severe asthma in adolescents is estimated at 6.7%. Transition to adult health services is a vulnerable period for adolescents where there is a risk of poor treatment adherence and loss to follow-up.
This retrospective study evaluated the maintenance of asthma control in young severe asthmatics, 6 months and 1 year after transition to a specialist adult centre.
Patients with severe asthma treated in a paediatric pulmonology centre in the Île-de-France and referred at least 6 months previously to an adult service were included. Asthma control was evaluated by measuring the ACT score and respiratory function. Patients were asked to answer an on-line questionnaire about their experiences during transition.
Fifty-four adolescents with severe asthma underwent transition to the adult service between 2014 and 2021. Thirteen patients (25%) were lost to follow-up after an average of 22.4 months of follow-up. Three-quarters (73%) of patients had well controlled asthma with an ACT score ≥20 during transition and the majority were able to maintain good control and respiratory function (>60% FEV >80%) during follow-up in adult pulmonology. Among the patients that answered the questionnaire, 64.8% were satisfied with the transition process.
Asthma control and respiratory function were maintained 6 months and 1 year after transition to the adult centre in the majority of patients. Most patients were satisfied with the transition process, but several improvements can be proposed, including early discussion of the medical plan and the implementation of procedures to reduce loss to follow-up.
据估计,青少年重度哮喘的患病率为6.7%。向成人医疗服务过渡对青少年来说是一个脆弱时期,在此期间存在治疗依从性差和失访的风险。
这项回顾性研究评估了年轻重度哮喘患者在转至成人专科中心6个月和1年后哮喘控制情况的维持情况。
纳入在法兰西岛的儿科肺病中心接受治疗且至少在6个月前转诊至成人医疗服务机构的重度哮喘患者。通过测量ACT评分和呼吸功能来评估哮喘控制情况。患者被要求回答一份关于他们在过渡期间经历的在线问卷。
2014年至2021年间,54名重度哮喘青少年转至成人医疗服务机构。平均随访22.4个月后,13名患者(25%)失访。四分之三(73%)的患者在过渡期间哮喘得到良好控制,ACT评分≥20,并且大多数患者在成人肺病科随访期间能够维持良好的控制和呼吸功能(>60% FEV>80%)。在回答问卷的患者中,64.8%对过渡过程感到满意。
大多数患者在转至成人中心6个月和1年后哮喘控制和呼吸功能得以维持。大多数患者对过渡过程感到满意,但可以提出一些改进建议,包括尽早讨论医疗计划以及实施减少失访的程序。