Davidse Kirsten, van Staa Anneloes, Geilvoet Wanda, van Eck Judith P, Pellikaan Karlijn, Baan Janneke, Hokken-Koelega Anita C S, van den Akker Erica L T, Sas Theo, Hannema Sabine E, van der Lely Aart Jan, de Graaff Laura C G
Department of Internal Medicine-Endocrinology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.
Endocr Connect. 2022 May 25;11(5):e220025. doi: 10.1530/EC-22-0025.
Transition from paediatric to adult endocrinology can be challenging for adolescents, their families and healthcare professionals. Previous studies have shown that up to 25% of young adults with endocrine disorders are lost to follow-up after moving out of paediatric care. This poses a health risk for young adults, which can lead to serious and expensive medical acute and long-term complications.
In order to understand and prevent dropout, we studied electronic medical records of patients with endocrine disorders. These patients were over 15 years old when they attended the paediatric endocrine outpatient clinic (OPC) of our hospital in 2013-2014 and should have made the transfer to adult care at the time of the study.
Of 387 adolescents, 131 had an indication for adult follow-up within our university hospital. Thirty-three (25%) were lost to follow-up. In 24 of them (73%), the invitation for the adult OPC had never been sent. We describe the failures in logistic processes that eventually led to dropout in these patients.
We found a 25% dropout during transfer from paediatric to adult tertiary endocrine care. Of all dropouts, 73% could be attributed to the failure of logistic steps. In order to prevent these dropouts, we provide practical recommendations for patients and paediatric and adult endocrinologists.
对于青少年及其家庭以及医疗保健专业人员而言，从儿科内分泌科过渡到成人内分泌科可能具有挑战性。先前的研究表明，高达25%患有内分泌疾病的年轻人在脱离儿科护理后失去了随访。这给年轻人带来了健康风险，可能导致严重且昂贵的医疗急性和长期并发症。
为了了解并预防失访情况，我们研究了内分泌疾病患者的电子病历。这些患者在2013 - 2014年到我院儿科内分泌门诊就诊时已超过15岁，且在研究时应已转至成人护理。
在387名青少年中，131人有在我们大学医院接受成人随访的指征。33人（25%）失访。其中24人（73%）从未收到过成人门诊的邀请。我们描述了最终导致这些患者失访的后勤流程中的失误。
我们发现在从儿科向成人三级内分泌护理过渡期间，失访率为25%。在所有失访病例中，73%可归因于后勤步骤的失误。为了预防这些失访情况，我们为患者以及儿科和成人内分泌科医生提供了实用建议。
